Instruction: create a high quality summary of the given input

Input:
Invitae to expand services into whole life genetic testing
 San Francisco-based genetic diagnostics company Invitae has acquired Good Start Genetics and CombiMatrix, expanding Invitae’s portfolio to include prenatal and pediatric testing. It’s part of their long-term plan to make genomic testing routine.

“We’re building a company for the coming genomic era that includes genetic capabilities through all phases of life,” said Invitae CEO Sean George in a phone interview.

Invitae offers a wide range of genomic panels to detect anomalies that could contribute to heart disease, cancer, neurologic disorders and other conditions. In Good Start, Invitae picks up expertise in carrier screening and preimplantation genetic testing. CombiMatrix also provides preimplantation testing, as well as panels to analyze miscarriages and pediatric developmental disorders.

Invitae is issuing 1.65 million shares of stock, paying $18.3 million in cash and assuming $6 million in debt for privately-held Good Start. CombiMatrix shareholders will receive around $27 million in common stock.

Spun off from Genomic Health in 2012, Invitae initially focused on adult inherited diseases and has gradually expanded their portfolio. They now enter a crowded field that includes LabCorp (which acquired Sequenom last year), Illumina, Progenity and others. George believes Invitae’s ability to “do the hard things” will carry them through these market battles.

“We are building a technology engine to win the race of scale,” said George. “We are looking to the OB market and the perinatal space to extend our platform’s capabilities. But more importantly, in order to move the world away from the current disease-by-disease, test-by-test market, it’s managing genetic information for an individual over the course of their life.”

Good Start appealed to Invitae for their cost-effective pre-implantation screening and diagnosis. CombiMatrix brings specific expertise in chromosomal microarrays. In addition, the companies could expand Invitae’s marketing reach.

“The two together have a pretty good commercial presence in the IVF and reproductive medicine sector,” said George. “Combined, especially with our capabilities, I think it’s fair to say we are immediately the number one player in the IVF, reproductive medicine segment for genetic information.”

These acquisitions add around 150 people to the Invitae payroll, a 20 percent workforce increase. George notes they are always looking around for potential acquisitions but will probably take a breather to focus on moving new products to market. Ultimately, Invitae wants to be the company that mainstreams clinical genomics.

“With the broad capabilities we now have at all stages of life, we expect to get traction in this new age of genomic medicine, where all this information can be brought to bear,” said George. “The first company to have broad capabilities across all of it and to continue to lower the cost basis and deliver that information is likely in position to truly bring genetics into medicine for everybody.”

Photo: mediaphotos, Getty Images

Output: San Francisco-based genetic diagnostics company Invitae has acquired Good Start Genetics and CombiMatrix to add prenatal and paediatric testing to its services. Good Start offers carrier screening and preimplantation genetic testing, while CombiMatrix provides preimplantation testing as well and also panels for analysing miscarriages and paediatric developmental disorders. Invitae is aiming to be a leader in supplying genetic information for in-vitro fertilisation and reproductive medicine. Invitae will pay $18.3m in cash and assume $6m in debt for Good Start, and will issue $27m in common stock to CombiMatrix shareholders. Invitae wants to expand its genetic services to all stages of life.


Instruction: create a high quality summary of the given input

Input:
Coinbase to credit users with Bitcoin Cash after lawsuit threat
 Earlier this month, an activist group formed by Coinbase users created the Coinbase Bitcoin Cash Lawsuit Portal, to file a lawsuit against the world’s largest Bitcoin wallet platform and exchange if they declined to credit users with Bitcoin Cash (BCH).

The issue has now been resolved as Coinbase released an official company announcement to clarify that all account holders before Aug. 1 on Coinbase will be credited with BCH. Coinbase director of communications David Farmer wrote:

“We are planning to have support for Bitcoin Cash by Jan. 1, 2018, assuming no additional risks emerge during that time. Once supported, customers will be able to withdraw Bitcoin Cash. We’ll make a determination at a later date about adding trading support.”

Coinbase even plans to integrate BCH trading later in 2018, which not a lot of Bitcoin exchanges have done. So far, the big three Bitcoin exchanges in China including BTCC, Huobi, OKCoin and the South Korean Bitcoin exchange market’s two largest trading platforms Bithumb and Korbit have integrated BCH support.

Was the Coinbase lawsuit realistic?

The Coinbase Bitcoin Cash Lawsuit Portal threatened the Bitcoin industry’s only billion dollar company with a class action lawsuit led by attorney Priyanka Ghosh-Murthy. She confirmed Fortune that a complaint on invoking negligence, breach of fiduciary duty and unjust enrichment will be filed in Florida.

“Meanwhile, an attorney named Priyanka Ghosh-Murthy told Fortune she intends to file a complaint—invoking negligence, breach of fiduciary duty and unjust enrichment—in Florida by the end of the week,” Fortune reported.

However, prior to the Aug. 1 hard fork, Coinbase, as well as its digital assets exchange arm GDAX, clarified in official company blog posts that they don’t intend to support the BCH fork. The two companies emphasized that they are not confident if they can support it securely.

Adam White, vice president of GDAX, stated:

“This means if there are two separate digital currencies — Bitcoin (BTC) and Bitcoin Cash (BCC) — customers with Bitcoin stored on GDAX will only have access to the current version of Bitcoin we support (BTC). Customers will not have access to, or be able to withdraw, Bitcoin Cash (BCC). Customers who wish to access both Bitcoin (BTC) and Bitcoin Cash (BCC) need to withdraw Bitcoin stored on GDAX before 11:59 p.m. PT July 31, 2017. If you do not wish to access Bitcoin Cash (BCC) then no action is required.”

Considering the fact that Coinbase did clarify to its users prior to the hard fork execution that the two companies will not be supporting BCH, whether the lawsuit would have been realistic still remains in question.

Already, Coinbase and GDAX have published updates on their stance on Bitcoin Cash and the two platforms may even integrate BCH trading by early 2018.

Output: Coinbase has told users that all account holders before August 1 will be credited with bitcoin cash (BCH) after it faced the threat of a lawsuit. An activist group formed by Coinbase users threatened to file a lawsuit earlier this month if the bitcoin wallet platform and exchange declined to credit users with BCH. The issue was later resolved when Coinbase released an official announcement, adding that it plans to support for BCH by 1 January 2018. It also plans to integrate BCH trading later next year.


Instruction: create a high quality summary of the given input

Input:
Redrow Councillor concerned over Poulton, Lancashire developments
 The site in Carr Head Lane

Alf Clempson is concerned about damage being caused by building traffic and the use of thousands of tonnes of hardcore to stabilise land.

Coun Clempson has repeatedly stated his opposition to a number of developments, including one now being built by Redrow in Carr Head Lane.

Advertisement Hide Ad

Advertisement Hide Ad

And he says works going on at the site show the challenges of developing the land, and nearby sites including Holts Lane, where planning permission was granted for more homes.

He said: “I’ve heard they have had to take tonnes and tonnes of hardcore onto the site, just to stabilise the road, that’s just for the road.

“Goodness knows what you’ll need to build the houses. This is not good land to build on, neither is Holt Lane, we’re starting to see that. Near the site we’ve had pavements repeatedly damaged and repaired because of lorries.”

Coun Clempson says Poulton will suffer from over development and hopes home builders might think again.

Advertisement Hide Ad

He said: “On two of the sites planning permission has been gained for them to be sold on to developers.

“I would hope anyone might think twice about these plots.

Advertisement Hide Ad

“If all the development goes ahead you’ll get 1,000 new homes around Poulton, the town can’t cope.”

Coun Clempson is disappointed that Redrow boss Steve Greenhalgh turned down an invitation to hold talks over the site.

The firm said it had made the site manager’s contact details available for concerned residents.

Advertisement Hide Ad

Output: Councillor Alf Clempson, has voiced concerns over damage from building traffic and thousands of tonnes of hardcore being used to stabilise land for housing developments in Poulton, Lancashire, including one being built by Redrow in Carr Head Lane. He claims the land is not good to build on, citing the amount of hardcore required, and suggests the market town will suffer from over development, with further permission granted for more homes on nearby sites, including Holts Lane. Clempson was disappointed Redrow MD (Lancashire) Steve Greenhalgh turned down an invitation to hold talks over the site.


Instruction: create a high quality summary of the given input

Input:
South Korean tech employees mining bitcoin with store electricity
 Earlier this week, Yongsan Electronics Market, an iconic center in South Korea which houses some of the largest electronic retailers and South Korean headquarters of major computer manufacturers including ASUS, officially banned Bitcoin mining after discovering that some of its smaller stores have used Yongsan Electronics Market’s electricity to mine Bitcoin.

Bitcoin mining craze

Local sources including Hankyung revealed that some stores established mining equipment to mine Bitcoin with the market’s electricity. Employees of certain computer retail stores even had normal CPUs running overnight mining Bitcoin.

Owners of computer stores and electronics retailers submitted formal complaints to the Yongsan Electronics Market management and expressed their concerns over overheating computers posing as a potential fire hazard.

In fact, in early 2013, many cryptocurrency enthusiasts in South Korea tried to mine Litecoin, which had significantly lower difficulty levels than Bitcoin, with normal CPUs or computers. After days of running Litecoin mining software, some reported that the motherboards of their laptops melted due to extreme overheating.

In a public statement, the Yongsan Electronics Market announced:

“Running of Bitcoin mining equipment results to significant consumption of electricity within the center. If electric consumption reaches its limit, electricity costs will drastically increase and they will have to be covered by merchants, computer stores and electronic retailers within the center. Some merchants and stores submitted formal complaints that due the rapid increase in electricity consumption caused by Bitcoin mining, air conditioners stopped functioning properly.”

During an investigation, the Yongsan Electronics Market management discovered that some stores that were initially rented out as computer stores were being used as Bitcoin mining centers, with ASIC miners and GPUs in racks placed throughout the space. The management further revealed that consumers and clients passing through stores that had Bitcoin mining equipment running felt a drastic increase in temperature in the area.

“100 ASIC miners running simultaneously”

The Yongsan Electronics Market management noted that one store had $300,000 worth of ASIC miners and GPUs running full time, 24/7, to mine Bitcoin and other cryptocurrencies.

“One store had over 100 ASIC miners running simultaneously, which led to an unexpected rise in energy consumption,” the management added.

Bitcoin mining, which once was a lucrative business and industry, has become increasingly difficult to profit from.

Major mining pools including Antpool, which is operated by arguably the most influential Bitcoin mining equipment manufacturer in the industry Bitmain, also struggle to record high-profit margins despite exponential development in ASIC miners and Bitcoin mining equipment.

Last month, Cointelegraph previously reported that the South Korean government has officially legalized and approved Bitcoin as a remittance method, similar to the Philippines.

When the South Korean government and financial regulators fully legalize and regulate the South Korean Bitcoin exchange market, clarity on Bitcoin mining will also be provided.

Output: Yongsan Electronics Market, a shopping centre in South Korea, has banned bitcoin mining after it found some stores were using its electricity to mine the cryptocurrency. Once store ran $300,000 worth of ASIC miners and GPUs around the clock to mine bitcoin and other cryptocurrencies, the electronics market said. The rapid increase in electricity consumption caused air conditioning units to stop functioning properly, it added.


Instruction: create a high quality summary of the given input

Input:
Autonomous vehicles get dangerously confused by graffiti
 While car makers and regulators are mostly worried about the possibility of self-driving car hacks, University of Washington researchers are concerned about a more practical threat: defacing street signs. They've learned that it's relatively easy to throw off an autonomous vehicle's image recognition system by strategically using stickers to alter street signs. If attackers know how a car classifies the objects it sees (such as target photos of signs), they can generate stickers that can trick the car into believing a sign really means something else. For instance, the "love/hate" graphics above made a computer vision algorithm believe a stop sign was really a speed limit notice.

It's easy to see the potential problems. You could make these stickers using a printer at home, so anyone from dedicated attackers to pranksters could try this. It might lead to a crash the moment someone alters the sign, but it could also produce long-term chaos -- picture your city closing a road until maintenance crews can scrape the stickers off a sign.

There are ways to fight this. The research team suggests using contextual information to verify that a sign is accurate. Why would you have a stop sign on the highway, or a high speed limit on a back road? We'd add that local governments could also install signs that use an anti-stick material, or put them out of reach. Whatever happens, something will have to change if passengers are going to trust self-driving cars' sign-reading abilities.

Output: Autonomous vehicles could completely ignore road signs should they be damaged or covered in graffiti, researchers from the University of Washington have said. The scientists gained access to visual recognition software used in self-driving vehicles and found that simple manipulation of signs by anyone with access to a printer could cause vehicles "to misbehave in unexpected and potentially dangerous ways". For example, a stop sign with graffiti added was misread as a speed-limit sign.


Instruction: create a high quality summary of the given input

Input:
Arsenal's Emirates Stadium aims for 100% sustainability
 Join our growing army of changemakers and get unlimited access to our premium content

Announced late last week, the deal will see Octopus Energy power Arsenal’s Emirates Stadium using renewable energy generated across an array of solar farms operated by the energy start-up firm.

The move follows a year-long trial at Arsenal which boosted the club’s use of renewable energy. Arsenal’s chief executive Ivan Gazidis noted that it was “important” that football clubs take steps in this area.

Octopus Energy’s chief executive Greg Jackson added: “The technology to create electricity from renewable sources is now so efficient, that we can offer ‘green’ energy to our customers which is cheaper than many ‘non-green’ tariffs. Being green doesn’t have to cost the earth.

“We have been delighted to work with such an awesome club as Arsenal, and are looking forward to continuing our partnership into the future.”

While the deal with Octopus Energy makes Arsenal the first Premier League club to switch to 100% renewables to power a stadium, the club has previously implemented various sustainability initiatives at the ground in Ashburton Grove.

The Emirates Stadium is fitted with water recycling systems, while all surplus or waste food is sent to an anaerobic digestion (AD) plant, which is turned into energy that is then fed back to the club. The use of voltage optimisation equipment and LED lights have also reduced power use by up to 20%.

Gunning for green

The club’s former midfielder Mathieu Flamini is also making waves in the low-carbon market, after revealing an eight-year secret plan that has seen him set up a market-leading biofuel technology firm in a sector worth up to £20bn.

The French footballer set up GF Biochemicals in 2008, and it is reportedly a leader in developing levulinic acid (LA) – a green alternative to oil that can be used in biofuels, cosmetics, plastics and food preservatives.

Elsewhere in the Premier League, newly-promoted Newcastle United is pursuing a “carbon positive” status and recently installed a combined heat and power (CHP) system at its own St James Park Stadium, to reduce the football club’s emissions by more than 390 tonnes every year.

On the back of Manchester City Football Club partnering with an energy storage company earlier this year, edie took a closer look at how the club incorporated sustainable business practices into its multi-billion pound transformation, in line with its rise up the Premier League table.

Matt Mace

Output: Emirates Stadium, home of Arsenal FC, has become the first Premier League stadium to run on 100% renewable energy. Arsenal extended its deal with supplier Octopus Energy, which sells the club energy generated at wind farms. This comes after a year-long trial at the football club, with chief executive saying it was "important" to edge towards renewable energy.


Instruction: create a high quality summary of the given input

Input:
NMU replaces computer policy with all-in-one cyber cover product
 The new policy replaces NMUs existing computer offering.

NMU has launched a computer, data and cyber policy insurance.

The provider detailed that the new policy would replace its existing computer offering.

It noted that the frequency of data breaches - the theft, loss or mistaken release of private information, was on the rise.

Cover

As such the all in one policy covers: hardware (including portables) and data corruption which provides protection for assets, data breach expense, cyber crime, cyber liability and cyber event, and, loss of business

Output: NMU has launched an all-in-one cyber insurance policy for small businesses that will cover policyholders for data and hardware corruption, protection of assets, data breach expenses, cyber crime, cyber liability and cyber event as well as loss of business income. The policy replaces its earlier computer coverage product and has been launched in response to an increase in data breaches. "Data breaches aren’t just a big business problem; small and medium-sized businesses with fewer data security resources are particularly vulnerable," said executive director Nick Limb.


Instruction: create a high quality summary of the given input

Input:
Allianz's LV purchase will reduce competition, warn brokers
 However, experts also see opportunities rising from the merger.

Following the announcement from Allianz that it has bought 49% of LV’s general insurance business, brokers have stated that the coming together of the two providers will reduce choice in the personal lines market.

Allianz noted that the move will see the insurers join forces to create a £1.7bn premium personal lines business under the LV brand, with the insurer planning to own 69.9% long term, paying £713m in total.

While brokers were not surprised by the deal, following market speculation

Output: Allianz's purchase of 49% of LV’s general insurance business will decrease potential choices in the UK's personal lines sector, brokers have said. The insurance companies' partnership will create a £1.7bn premium personal lines business operating under LV branding, with Allianz planning to eventually own 69.9% of LV for £713m in total. Brokers are concerned there will be a lack of variety in underwriting, with a small market to choose from.


Instruction: create a high quality summary of the given input

Input:
WPP to double Snapchat investment
 WPP will double its spend on Snapchat this year, investing an estimated $200m according to the network’s chief Sir Martin Sorrell.

Snapchat

It comes after WPP tripled its investment into the platform in 2016. Its clients spent $90m on Snapchat last year, around $60m more than it predicted would be spent on the app.

Output: WPP is set to double spending on Snapchat this year, with an investment of around $200m. Last year WPP tripled investment in the social platform, with clients spending $90m compared to an expected $30m. However, budgets going into Snapchat pale in comparison to the $6bn spent on Google or the $2bn on Facebook by advertisers. Snapchat CEO Sir Martin Sorrell said that WPP spent $1.7bn on Facebook in 2016, and expects its 2017 investment will be upwards of $2bn.


Instruction: create a high quality summary of the given input

Input:
Catella expects sustainable real estate funds to prosper in 2018
 × Expand Dr. Thomas Beyerle Dr. Thomas Beyerle ‘Today, there are around €2.73b invested in so-called sustainable property funds in Europe,’ said Thomas Beyerle, head of group research at Catella.

Sustainable real estate funds are on the rise, according to Catella’s latest market tracker ‘Sustainable funds in the real estate industry – a look at Europe’, published this month.

In particular, investors are focusing on sustainable funds in Germany, Austria and Switzerland, according to Catella, which expects them to grow to €3.2b by 2018.

‘Today, there are around €2.73b invested in so-called sustainable property funds in Europe,’ said Thomas Beyerle, head of group research at Catella. ‘At first glance, that looks like a lot, but overall in Europe the volume is around €11.04tr., so these products are carving out a niche existence.’

Catella has identified nine property funds that are managed as sustainable funds, according to Beyerle. In Germany, property funds account for 17% of the sustainable investment market, compared to 20% in Switzerland and just 1.7% in Austria, according to Catella.

Last month (June), Catella Real Estate launched an open-ended sustainable private real estate fund together in conjunction with the Bank im Bistum Essen (BIB) and the Bank für Kirche und Diakonie (KD-Bank).

The fund - known as KCD-Catella Nachhaltigkeit Immobilien Deutschland - is an investment vehicle designed for religious, charitable, welfare, and church-related institutions and foundations. It will have an investment volume of €260m, including 30% gearing and will mainly invest in ‘Top 7’ cities and in metropolitan regions, such as university cities, in Germany. In May, Catella acquired its first office building for the fund, a 3.920 sqm building in Frankfurt for just under €20m.

‘This is the first open-ended fund we have launched for two church banks,’ said Dr. Tim Schomberg, head of Business Development Institutionals at Catella Real Estate. ‘The banks approached us about launching the fund because they had already invested in earlier funds of ours. We created a sustainability monitor for them, tailored to meet their Christian, clerical, ethical code. We could also roll out the sustainability monitor to other funds in the future.’

Potential properties for the fund will be analyzed using the sustainability monitor designed by Catella in partnership with the Institut für Markt, Umwelt und Gesellschaft (IMUG), which considers factors such as energy efficiency, value retention, climate protection, water consumption and user well-being.

Up to 60% of the fund will invest in offices, with an additional 40% maximum invested in retail. The fund can also invest 10% to 20% in residential stock and up to 20% in properties with charitable, welfare, or social utilization.

Output: Catella's recently published "Sustainable funds in the real estate industry - a look at Europe" suggests that the number of sustainable real estate funds is increasing. Investors seem particularly keen to focus on such funds in Austria, Germany and Switzerland, with Catella expecting the market to grow from €2.73bn to €3.2bn by next year. In German, property funds make up 17% of the sustainable investment market, with 20% in Switzerland and only 1.7% in Austria.


Instruction: create a high quality summary of the given input

Input:
Chicago hotels are outsourcing room service meals to local chefs
 Thank you for supporting our journalism. This article is available exclusively for our subscribers, who help fund our work at the Chicago Tribune.

Richard Jones, executive chef at the Public House gastropub in Chicago, talks about partnering with an off-site hotel to provide room service to hotel guests. (Terrence Antonio James / Chicago Tribune) (Terrence Antonio James / Chicago Tribune)

Hotel room service has always been a tough sell.

It's expensive both to order and to operate, looks extravagant on a business traveler's expense report, and for most people, goes against the very point of travel: to get out and explore new sights and cuisines. Room service revenue industrywide is down more than 25 percent since before the recession, according to CBRE, a commercial real estate firm.

Advertisement

Still, some members of the traveling public want the option of food delivered to their rooms, and hotels are eager to offer solutions that will differentiate them from competitors without breaking the bank.

For a few Chicago hotels, that has meant delivering meals to guest rooms through partnerships with a popular local gastropub, a cult-favorite burger chain and a hometown service that delivers organic, chef-made meals.

Advertisement

"The economics of running a food and beverage operation can be a strain, so (some hotel operators) are looking for more creative ways to serve guests," said Scott Berman, the U.S. hospitality and leisure practice leader at PwC.

While hotels and food providers generally don't reveal financial details of these partnerships, the benefits are clear. It gives the hotels a valuable marketing tool in offering food delivery without the high cost of producing it themselves, and provides added exposure and a broader customer base for the restaurant or food delivery company.

The Kinzie Hotel in Chicago's Near North neighborhood didn't have to stray far to find a room service provider. The hotel inked a deal with gastropub Public House, which sits next door. Public House is now the sole provider of room service meals to the hotel, for lunch, dinner or a pared down menu for late night.

Sliders prepared at Public House restaurant, 400 North State Street in Chicago, are nearly ready for transport to the nearby Kinzie Hotel on Wednesday, Aug. 2, 2017. Guests at the Kinzie can order room service meals from Public House. (Terrence Antonio James / Chicago Tribune)

Andrew Eck, the hotel's general manager, says Public House works well for the hotel because of its varied menu and "essential Chicago" feel.

"I thought the chance to partner with a trendy gastropub and take advantage of their popularity with locals was exciting for the people that weren't able to explore the city as much or wouldn't get to experience Public House in person," Eck said. No money changed hands in the partnership.

An in-room order from Public House comes with an automatic 20 percent gratuity included and a delivery fee of $3.50.

Staff from the hotel and the restaurant have met frequently since starting the service last year to perfect the offering and solve any problems quickly, Eck says. But so far, he said they haven't had to make major adjustments to offerings or service. The food is served on plates used in the restaurant, instead of in takeout containers, to improve the perception by guests, Eck said. He estimates that about 20 to 30 room service orders are placed on busy nights at the 215-room hotel.

Public House meals are delivered to the hotel by restaurant staff and brought up to a guest's room by employees of the hotel. Eck said guests order from other delivery services very rarely, in part because the Public House menus are featured so prominently in guest rooms.

Advertisement

Richard Jones, executive chef at Public House restaurant, oversees preparation of a meal for delivery to the nearby Kinzie Hotel on Aug. 2, 2017, in Chicago’s Near North neighborhood. Guests at the Kinzie can order room service meals from the gastropub. (Terrence Antonio James/Chicago Tribune)

Room service is an important draw for the Kinzie's business travelers, who often don't have time to go out to restaurants, or travel to Chicago in the winter months, when eating in the warmth and comfort of a hotel room seems more appealing than trudging through snow to eat out, expense account or not.

Eck estimates that about 30 percent of the Kinzie's rooms are filled with business travelers in the summer. That figure swells to about 70 percent in the winter.

A new Shake Shack restaurant on the ground floor of the Chicago Athletic Association Hotel in the Loop meant a new option for guests to order from, and marked the first time that the burger and custard chain had ever done room service.

Mike Bravo, left, a delivery driver with the Eat Purely food service, delivers a meal Aug. 2, 2017, to a guest at Hotel Chicago on Chicago’s Near West Side. The service offers a handful of chef-made organic meals each day that can be delivered in 30 minutes. (Terrence Antonio James/Chicago Tribune)

Shake Shack spokeswoman Kristyn Clark said the partnership, which began last August, is unique to this hotel and isn't expected to be replicated at other Shake Shack locations.

Hotel Chicago on the Near West Side, which opened in April of last year, doesn't have a built-in restaurant and initially filled the gap by offering guests 10 percent off at neighboring Park Tavern and Angel's, a Mexican restaurant. But General Manager Imran Jivani also wanted a healthy and quick delivery option for the large number of young people and medical professionals who stay at the hotel because of its proximity to the Illinois Medical District and the United Center. Hotel Chicago and the Kinzie are both owned by Westmont-based Portfolio Hotels and Resorts.

Chicago-based meal delivery service Eat Purely turned out to be a "perfect fit," he said. Eat Purely offers a handful of chef-made organic meals each day that can be delivered in 30 minutes.

Advertisement

He estimates between 5 and 10 percent of guests in the 116-room hotel use the service regularly, and many order multiple meals that can be refrigerated and microwaved in their rooms. As with the Kinzie, no money changes hands in the The Hotel Chicago-Eat Purely deal.

"People have loved it," he said. "It works for any discerning customer or someone who wants all the bells and whistles."

Eat Purely meal delivery may also be a way of helping hotel guests break out of their routines.

Chicago visitors tend to stick to the familiar when staying at hotels in the city, according to delivery company DoorDash. The most popular restaurants for DoorDash hotel deliveries in Chicago are The Cheesecake Factory and Buffalo Wild Wings. But those hotel dwellers willing to try local restaurants most frequently chose Doc B's, Duck Duck Goat, Big Bowl, The Chicago Diner and Big Star, according to the company.

While smaller boutique hotels have found solutions to their room service dilemmas, large chains have been experimenting with partnerships too.

Hyatt Centric, a Hyatt chain aimed at younger travelers, launched a "Restaurant to Go" service in which guests could order from restaurants or an express menu and have food delivered to their rooms in 20 minutes. As part of that program, the brand formed a pilot program with Grubhub to provide room service delivery from a curated set of restaurants at its hotels in Miami; Park City, Utah; and Long Beach, Calif. Local hotel employees picked seven to 10 restaurants for each property, and ordering goes through a customized webpage that's provided at check-in.

Advertisement

Grubhub wouldn't offer financial details of its partnership with Hyatt, but said that hotel guests tend to spend more on orders overall.

Sandra Cordova Micek, senior vice president of global brands at Hyatt, said the collaboration has been "received enthusiastically," and that the hotel chain is "looking forward to evolving the relationship."

sbomkamp@chicagotribune.com

Twitter @SamWillTravel

Output: Several hotels in Chicago are delivering meals to guest rooms through partnerships with local restaurants. The deal enables hotels to offer food delivery without producing it themselves and provides the food delivery company exposure to a broader customer base. Gastropub Public House, the first participant in the scheme, hasn't made major adjustments to its offering or service since it partnered with the Kinzie Hotel in Chicago's Near North neighbourhood, the hotel's general manager said.


Instruction: create a high quality summary of the given input

Input:
Perceptions of Aging Are Shared Across the Generations
 Photo via Pixabay

By Joey Collado

WESTliving, the organization that operates the senior living community that I manage, is a private family business founded through the efforts of Gary and Mary West. The Wests are also philanthropists and committed to successful aging.

They have established a nonprofit institute that funds research into successful aging and develops solutions to support seniors and their quality of life. The Gary and Mary West Health Institute recently shared some interesting findings regarding our perceptions of aging.

Their study showed that the things that concern us most about aging remain stable throughout our lives.

People’s fears about don’t differ much regardless of what generation they’re from. What that means to you, if you have aging parents, is that they’ll likely have the same concerns as you and your Millennial children. That should be comforting. It means you’ll all be able to find common ground in conversations about maintaining your parents’ quality of life as they age.

The study found that memory loss, financial security and health issues are the top three concerns across all generations, followed closely by worries about losing independence or having to move to a nursing home.

Another interesting finding was that people in their 30s through 50s have a negative perception of whether government programs meet the needs of seniors, whereas seniors who have been exposed to the programs feel more positively about them. This should also come as a relief to adults with aging parents as it indicates that a little more awareness could go a long way toward easing worries about the services and programming available to their parents.

The study reports, “About a third of adults in their 30s, 40s and 50s do not think such government programs are meeting the needs of seniors, compared to 26 percent of people in their 60s and 14 percent of people in their 70s or older.”

Researching options for our aging loved ones should bring relief as we become more informed about the variety of programming available and can advocate for their unique care needs. Ensuring a stable environment from a financial, health and emotional perspective is essential, as is privacy and accessibility to activities that respect independence needs.

When we commit to helping our elderly loved ones live their lives to the fullest—what we call inspired aging—we focus on creating opportunities to be mentally, physically and socially engaged and emphasize independence. It sounds like common sense to us, but it helps to see research confirm it.

The study was conducted by the West Health Institute and NORC at the University of Chicago and can be found online.

Joey Collado is the General Manager at The Montera, a San Diego County senior living community offering independent, assisted, memory, dementia and short term stay care.

Output: WESTliving, the organization that operates the senior living community that I manage, is a private family business founded through the efforts of Gary and Mary West. The Wests are also philanthropists and committed to successful aging.


Instruction: create a high quality summary of the given input

Input:
Paying doctors more — now will they treat more poor Californians?
 It seems like a simple solution. Raise what you pay doctors for treating low-income patients, and they’ll treat more of them.

All those waits for appointments and physician shortages that have long plagued the state’s low-income health insurance program—a program that one out of every three Californians now relies on—could be remedied with a simple dose of economics.

But in health care, nothing is that simple.

Yes, while debate over the future of Obamacare waxes and wanes in Congress, California doctors are happily preparing for their first state pay increase in Medi-Cal in 17 years. Physicians and advocates for low-income patients pried a $325 million raise from a reluctant Gov. Jerry Brown, who was skeptical that a doctor pay increase would translate to better care.

Even so, civil rights groups and some California labor unions are suing the state to pay doctors significantly more—the latest in a long history of legal actions that blame meager Medi-Cal reimbursement rates for delays in patient care.

One way or another, California doctors are likely to get a pay raise soon. Here’s what you need to know about how physicians may respond—and how it could impact the ability of 13 million Californians to see the doctors they need, when they need them.

How tough is it for Medi-Cal patients to get the care they need?

Overall, Medi-Cal patients have a tougher time getting the care they need than similar patients in other states, where the same program goes by its federal name, Medicaid. Recipients outside California are more likely to have visited a specialist and received a flu vaccination than recipients in California.

Medi-Cal recipients also were about 5 percent more likely to report delaying care because of difficulty getting an appointment.

Users of private insurance and Medicare (the federal health program for older people) typically fare better than Medi-Cal patients. Medi-Cal enrollees were more than twice as likely as adults with employer-sponsored insurance to use the emergency room as a usual source of care—a costly problem for the state.

Access problems are most severe for certain in-demand specialties such as psychiatry, which are even harder to come by for rural patients.

California has legally binding standards for access to care, including a maximum of a 15-day wait for specialist appointments and no more than a 90-minute drive to care for rural patients.

Unfortunately, the state has trouble collecting the data it needs to see if health plans it contracts with are actually complying with those standards.

This isn’t to say Medi-Cal is in utter disarray. Nearly 80 percent of Medi-Cal enrollees say the program provides access to most of the medical care they need. Interestingly, Spanish-speaking Latinos are among the groups most likely to report a positive experience with the program.

But without better data, it’s very difficult to know who’s doing the best and worst jobs of giving patient access—and how much difference higher reimbursements really make.

So just how stingy has California been to doctors?

California ranks 48th among all states in what it pays physicians for treating Medi-Cal patients, according to a recent and widely cited Urban Institute study. For primary care physicians, California ranks next to last—only Rhode Island pays less.

Those comparative rankings, however, are less definitive than they seem. They’re based on what the state pays on the “fee-for-service” portion of Medi-Cal, which only comprises about 20 percent of the program’s patients. Like the name entails, in “fee for service” the state pays doctors directly based off the services they provide: x dollars for a physical, y dollars for an MRI.

The remaining 80 percent of patients are in Medi-Cal managed care organizations—private health networks that receive a flat rate from the state for each patient they serve. The hope is that they can tamp down costs more effectively than the state could do on its own. Those managed care plans in turn contract with doctors—and those contract terms are confidential.

“The whole contracting process creates a black box and we don’t really know what’s going on in there,” says Gerald Kominski, director of the UCLA Center for Health Policy Research.

That makes it more difficult to easily incentivize those doctors to take on more patients. In fee-for-service, you can simply raise rates or target bonuses to certain physicians. In managed care, there’s a middleman.

While we don’t know precisely what the vast majority of Medi-Cal providers are being paid, it’s safe to assume that for most doctors it’s far less than employer-sponsored private insurers or Medicare.

Medi-Cal’s reimbursement rate for primary care has been just 41 percent of Medicare’s—meaning physicians have a much greater financial incentive to take on patients from Medicare than Medi-Cal.

Paying doctors more is going to entice them to see more patients, right?

Most research suggests that yes, raising reimbursement rates is associated with better patient access. States where Medicaid and Medicare reimbursements are about equal typically see higher provider participation rates in Medicaid than California.

“It may not be a simple linear relationship, but it’s fairly linear,” says Janet Coffman, associate professor of public policy at UCSF. “But you have to be a little careful extrapolating that out, especially to managed care.”

In fact, a recent experience with the rollout of the Affordable Care Act illustrates why. Rightly anticipating a massive swelling of Medicaid rolls, the Obama administration temporarily boosted Medicaid reimbursement rates to Medicare levels in 2013 and 2014 in the hopes of attracting more physicians to participate in the program.

But research was mixed: Some studies found that appointment availability increased for new Medicaid patients in certain states, while other states reported no increase in doctors willing to take on new Medicaid patients, and no uptick in patients seeing a primary care doctor.

Advocates for higher Medicaid reimbursements blame the mixed results on the flawed rollout of the pay raise—many doctors didn’t see the money they were promised for years after the policy was announced. Physicians also knew the increased payment rates were only temporary in most states, diluting the incentive to take on more low-income patients.

That’s the same obstacle California faces in structuring its own supplemental payments to Medi-Cal providers.

Doctors consider a lot more when deciding to take on poor patients

A marginal increase in reimbursements can be easily outweighed by the administrative strain of dealing with Medi-Cal. That’s especially true for providers without a lot of back office support, who could have difficulty making sure claims are paid on time. Many physicians also fear the risk of so-called “clawbacks,” when Medi-Cal recoups reimbursements paid to providers after a policy change or legal action.

Many doctors decide it’s just not worth it.

“If you’re a physician, you have to ask yourself, what is the administrative burden on me, how hard is it going to be for me to get paid from a Medi-Cal (managed care organization) plan, how easy is it going to be to get referrals?” says UCSF’s Coffman. “These administrative things matter.”

Geography also plays a part. If you work in a predominantly low-income community, you may have little choice but to see Medi-Cal patients. If you work in a richer area, you have more discretion. Rural areas like San Joaquin County or the northernmost stretches of the state, where Medi-Cal access is harder to come by, have a difficult time attracting doctors regardless of what type of insurance their residents have.

So how is the state planning to do this?

During negotiations with legislative leaders during budget season, the Brown administration expressed doubts about how higher payment rates translated to better patient access.

“The department has always indicated that funding and rates are only one element of access, and whether this will change access is a question,” says Mari Cantwell, chief deputy director of health care programs at the California Department of Health Care Services.

The state had options for how to distribute the $325 million in extra reimbursements approved in the budget. It could have tried to funnel payments to certain geographic areas in dire need of more physicians. It could have targeted specialty fields where doctors are in high demand. Or it could have offered higher reimbursement rates for treating new Medi-Cal patients.

Instead state health officials opted for a simpler approach—raising reimbursement rates across the board an average of 60 percent for all office visits, regardless of what type of doctor the patient sees or where the doctor works.

The result: Medi-Cal reimbursements for office visits will rise to about half of what Medicare pays, maybe more. While that sounds like a big jump, we’re talking about fairly nominal amounts per office visit. The biggest reimbursement raise—for seeing a new patient with complex illnesses—is $50.

The state also raised reimbursement rates for psychiatrists, given a severe shortage of Medi-Cal providers.

Still, the California Medical Association lobbied hard for the increase. This association of doctors calls it a cautious step in the right direction.

Calling the state’s plans for paying doctors more “encouraging,” medical association spokeswoman Joanne Adams wrote in an email that her organization would be “staying engaged” because how the program was carried out would determine its results.

California designed its plan to pass muster with federal health officials, who must approve the plan and have passed recent regulations limiting how states can direct extra payments to managed care organizations. The raises for providers in managed care programs will be similarly structured to the proposals in fee-for-service.

If approved, the payments would go into effect retroactively from July of this year.

The Brown administration also reserves the right to freeze the reimbursement raises should the federal government make major cuts to Medi-Cal. While that likely won’t affect this year’s payments, the money coming to doctors in future years is less secure.

CALmatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics. For more data points reporting by Matt Levin, go here

Output: It seems like a simple solution. Raise what you pay doctors for treating low-income patients, and they’ll treat more of them. All those waits for appointments and physician shortages that have long plagued the state’s low-income health insurance program—a program that one out of every three Californians now relies on—could be remedied with a simple dose of economics.


Instruction: create a high quality summary of the given input

Input:
Rocky Road Ahead for California Single Payer Proposal
 Despite rumors of its death, "the Healthy California Act," a bill that would create a massive single payer system for nearly all 39 million Golden State residents, is alive and essential. It's just waiting for enough political will that will bring it back for legislative hearings, and ultimately, passage later this year.

At least, that's what its proponents, including the California Nurses Association (CNA) and groups of frustrated physicians, passionately insist.

Some may now be complacent because the state is no longer in panic mode. They sense that last month's defeat of efforts to repeal Obamacare voided the threat that billions in federal cuts would cripple California's Medicaid funds and marketplace subsidies.

But the CNA (the Healthy California Act's key backer) and other supporters are certain the federal guillotine remains sharply suspended over the state's federally funded health programs.

"Just because the (repeal/replace) bills were defeated doesn't mean they've gone away," said Don Nielsen, the CNA's government relations director. "[Sen.] Lindsey Graham [R-S.C.] is working on another version." Additionally, Donald Trump has tweeted threats he will end federal subsidies for insurance companies and not enforce the individual mandate, both established under rules of the Affordable Care Act, Nielsen said.

Best Fix for Broken System?

People forget how broken California's system still is, he said. Even with the ACA, some 2.7 million people in the state remain uninsured and, for another 12 million, out-of-pocket expenses place many of their medical needs out of financial reach, he said. The Healthy California Act would make healthcare their right.

But the bill, SB 562, has been characterized by many as dead on arrival since late June, when state Assembly Speaker Anthony Rendon (D) shunted it to a committee, though it had passed with fanfare June 1 in the state Senate, 23-14.

Rendon did that, he said, because it contains severe gaps and controversial provisions.

Perhaps foremost among them: the bill doesn't say how its estimated $404 billion annual cost would be financed.

Nor does it indicate how the new system would control costs, or deal with the possibility that the Trump administration could reject the necessary federal 1332 waiver, allowing the state to divert Medicare and Medicaid funding -- an estimated $225 billion a year -- into a Healthy California Trust Fund, which would become the sole payer to qualified fee-for-service providers.

The bill has broad support from patient advocacy groups, teachers, churches, and many larger cities. Advocates note that employers would no longer pay huge sums to buy health coverage for their workers.

But far too many of its provisions make many important stakeholders unhappy.

The possibility that new employer fees would be required to fund the program make the bill especially unpopular with the Chamber of Commerce, agribusiness, and taxpayer groups. The state's insurance industry, represented by the California Association of Health Plans, would be essentially run out of business. Asked for comment, the CAHP referred to its June 1 press release that contends the plan would be too expensive.

The bill would, for example:

Essentially eliminate all health insurance companies, such as Kaiser Permanente, which covers some 8.5 million Californians. Their services would be relegated to cover the few that were not offered by Healthy California. Kaiser could still provide services like other hospital systems.

Eliminate the need for employer-sponsored insurance policies, an estimated $100 billion to $150 billion a year.

Cover all medical expenses for patients served in any typical healthcare setting, regardless of immigration status, with the exception of military personnel.

Eliminate all patient premiums, co-payments, co-insurance, deductibles, or cost-sharing, which some worry would lead to unnecessary visits and overutilization.

Cover more services than what many medical plans typically cover today, such as vision, dental, long-term, and substance abuse care.

Allow patients to select any qualifying provider, eliminating the concept of networks.

Allow Healthy California to negotiate prescription drug pricing.

Federal Assent Required

The bill could come up again when the legislature reconvenes August 21, or in committee session next spring. Efforts are apparently underway to amend the bill in back rooms, sources said. But whether compromises will go far enough is doubtful.

Asked by the CNA to study the issue this spring, a University of Massachusetts Amherst research group's May report suggested several ways Healthy California could work as a national model.

First, its $404 billion cost could be pared to $331 billion through efficiencies: removing administrative overhead, lowering pharmaceutical prices through negotiation, better management of provider fee structures, and by reducing unnecessary and inefficiently delivered services, missed disease prevention opportunities, and fraud.

In addition to Medicare and Medicaid dollars rerouted to Healthy California, the report identified two other possible sources of funding: a new gross receipts tax of 2.3% applied to all businesses with more than nine employees and a new sales tax of 2.3%, exempting housing, utility, and food used at home and certain services, the report said.

But a key concern is that federal 1332 waiver. Only two have ever been granted, to Hawaii last December and Alaska a week ago.

Ted Mazer, MD, president-elect of the California Medical Association (CMA), suggested that it's naive to believe "the federal government would turn over every federal dollar that it puts into healthcare over to the hands of California to do with it as they saw fit as a single payer ... Nobody had bothered to ask the federal government, 'would you consider that?'"

He also noted that pressure to do something at the state level has diminished, with the ACA still intact for the foreseeable future. "The uncertainty of what may come from Washington is still concerning," he said, "but for the time being the removal of threats to cut Medi-Cal payments ... makes California less pressured to find another system immediately."

The two key lawmakers who introduced the California bill, Democrat senators Toni Atkins and Ricardo Lara, declined to respond to requests for comment on the bill's chances.

But diehard support among some physician groups remains.

There's the California Physicians Alliance, a non-profit group whose platforms include advocacy for a single payer system. Member James Kratzer, MD, a solo-practice pediatrician in Fresno, said he's tired of dealing with 600 sets of insurance plan rules that cover different drugs, require different co-pays, and cover different services that are impossible to keep straight.

"Insurance companies inconsistently deny various services," he said, adding that the same plan will deny a benefit for one patient in the morning but allow it in the afternoon.

San Francisco family practice physician Jeff Gee, MD, advocates single payer conversion because insurance companies have become "my silent partner in the room. They pretty much guide decisions regarding diagnosis and treatment, referrals, who I can consult, and how soon I could see patients back ... what drugs I could order and tests."

His clinical expertise, he said, is "second-guessed by Aetna, and Blue Cross, while not contributing anything to the clinical encounter."

Docs Divided

But the Healthy California bill is far from universally popular among physicians.

Some physicians that have modeled their practices under Medicare and insurance plan risk-bearing models, where they're paid flat rates for episode based care, are nervous about a single payer disrupting their practices.

The current bill "doesn't incorporate any type of integrated delivery system model," said William Barcellona, senior vice president for government affairs for CAPG, which represents 300 multispecialty group practices in 32 states with bundled or capitated risk-bearing models.

"It's really more about what I call 1950s Marcus Welby-style medicine: independent solo practitioners practicing in a fragmented model," which may increase costs and impair continuity of care.

And Joseph Scherger, MD, vice president of a 60-physician primary care group at Eisenhower Medical Center in Rancho Mirage, said he doesn't think Americans (even those in California) are ready for a one-size-fits-all system for healthcare payment.

"We could sort of say that Kaiser [Permanente] got it right, and so now everybody in California will now have Kaiser. That might be a solution. But that's not America. America likes choice and variety and freedom, and wouldn't want to be forced into something like a Kaiser. So no, I don't see any real type of solution right now."

The CMA has not taken a formal position on the bill.

Mazer noted that California is often seen as a bellwether by clinicians in other states. He's heard doctors express concern that any significant movement of single payer legislation in a state as big as California could pressure their states to do the same. "Then they'd be stuck doing something that they can't afford or manage." Others have said a single payer system in California would attract un- and under-insured people from other states to move there, with potentially major adverse consequences.

Nielsen of the CNA thinks Rendon should relent, and let the bill be heard in open debate and then amended, but he declined to say what compromises his groups would be willing to accept.

"The legislative process is where all of these questions should be answered," he said. "Let's develop the political will."

Please enable JavaScript to view the comments powered by Disqus.

Output: Despite rumors of its death, "the Healthy California Act," a bill that would create a massive single payer system for nearly all 39 million Golden State residents, is alive and essential. It's just waiting for enough political will that will bring it back for legislative hearings, and ultimately, passage later this year.


Instruction: create a high quality summary of the given input

Input:
Health reform driving payer-provider partnerships
 Payers and providers have for decades stayed in their silos, leading to a more fractured and adversarial healthcare system. That relationship, however, is starting to soften for many in the industry. Payer-provider partnerships put the two groups on the same team in hopes of reducing costs and improving care and outcomes through sharing data and better communication.

A major driver of these partnerships is the move away from fee-for-service payments and toward valued-based payments and population health management.

“We’ve been tracking these partnerships for many years now and of the approximately 200 that have launched in the last five years, 92% are emphasizing value-based compensation in some shape,” Thomas Robinson, partner at Oliver Wyman, told Healthcare Dive.

The payer-provider partnerships popping up across healthcare vary in type, size, location and model. There are 50/50 joint ventures with co-branding, and less intensive partnerships like accountable care organizations (ACO), patient-centered medical homes (PCMH), pay for performance and bundled payments. Oliver Wyman found the partnerships can be broken down depending on providers’ appetite for risk.

The differences are endless, but they all focus on improving care for the individual patient. They do this through close communication between stakeholders, better interoperability and data-sharing, using data analytics to track patients and reducing administrative burdens.

Keys to partnerships: Trust, communication and a focus on the patient

The first step in these partnerships is building trust between payers and providers. Robinson said that can be difficult, as payers and providers may have an fractured relationship. Payers and providers can overcome differences by aligning around the big issues as early as possible, and establishing the right governance model.

Chuck Lehn, president of Banner Health Network, told Healthcare Dive a successful joint venture allows each organization to offer its administrative strengths and have a clear understanding of its roles and accountabilities.

“In our experience, we have found that streamlining the administrative pieces of our product can lead to better efficiency and a great member experience,” said Lehn.

Brigitte Nettesheim, president of transformative markets for Aetna, told Healthcare Dive partnerships necessitate a culture change, and participants need to understand they’re both in it for the long run. This requires aligning responsibilities and carefully crafting, negotiating and planning down to the most minute detail before the partnership is signed and executed.

Another key is communication. Lehn acknowledged that communicating across systems and platforms between two organizations and healthcare providers requires time, attention and resources. In a successful partnership, both sides need to communicate regularly and invest in technology, such as portals, so the two sides can share data seamlessly.

Caring for the whole patient works best when payers and providers share data, so there is improved care management, better interventions and better analytics around population health. This requires a capital commitment, so there is communication between not only payers and providers, but also between those two groups and patients, said Robinson.

The two sides can go much deeper into care for patients by going beyond claims. In partnerships, payers shouldn't have to wait for claims to see how their members are doing and doctors shouldn't have to hope that their patients tell them when they have received care elsewhere. All of that data should be shared freely and promptly.

“Most communication has been traditionally centered around transactions. That's just not sufficient anymore." James Leatherwood Marketing Communications Manager at Availity

James Leatherwood, marketing communications manager at Availity, told Healthcare Dive.

In addition to regular back and forth, payers and providers need regular meetings, whether monthly or quarterly, that focus on strategic issues about the partnership, said Leatherwood.

The third part of a successful partnership is aligning incentives that focus on keeping people healthy and creating a positive healthcare experience, said Robinson.

Partnerships must provide patients the right incentives, integration, investment, insight and innovation to work with the plan to deliver improvements across cost, quality, outcomes and experience, said Robinson.

“The point of these partnerships is to create something new, rather than just building the same old offerings with a narrow network. Successful partnerships will take the opportunity to innovate around the product and experience now that the incentives, insight, investment and integration are all for it,” said Robinson.

Partnerships to watch

Payers that are involved in partnerships vary from new players in the payer space like Oscar Health and Bright Health to large, established insurers like Aetna, various Blues and Cigna.

Here is a handful of the closely watched partnerships:

Aetna is one payer to watch in the partnership arena. Nettesheim said the company has committed to moving 75% of its contracts to value-based arrangements by 2020. Aetna is currently at 48%.

Aetna and Banner Health agreed on the partnership in October 2016 and have been laying out the groundwork before its launch this month in Maricopa and Pinal counties in Arizona. The two companies hope to expand the program statewide ultimately.

To prepare for the partnership, Tom Grote, who became CEO of Banner | Aetna joint venture in May, told Healthcare Dive that Banner Health and Aetna have developed joint operating committees, including marketing/sales and population health, that include members from both organizations.

The partnership looks to improve consumer experience by fully integrating providers, Aetna and administrative services, while eliminating redundancies in care and administrative problems. Aetna and Banner Health expect streamlining care and services will lead to savings for patients and employers.

Nettersheim said the partnerships are about “each side playing to its strengths, aligning incentives and driving scale.”

The two companies have worked together for more than five years on a separate ACO. The ACO has resulted in nearly $10 million in savings, a 24% drop in avoidable surgical admissions and increased generic drug prescribing rates by 4%, according to Aetna.

Grote said the key to partnerships is a common vision between the entities and leadership that healthcare needs to move to a value-based system.

“If we keep the customer — the end user — in mind and build partnerships with that as our North Star, we believe we will have a more successful, efficient and collaborative health system,” said Grote.

Nettersheim said most provider-sponsored health plans formed since 2010 haven’t shown a profit yet. In some cases, this is because they aren't yet able to scale up to what is needed to create profits.

Aetna’s partnerships with Banner, Allina and Sutter Health are still too new to find results, but Nettersheim is confident that Aetna’s partnerships will achieve scale by offering stability, expertise, volume and market power.

Another partnership to watch is Blue Cross Blue Shield of Michigan’s (BCBSM) PCMH, which is the largest medical home project in the country. The model is part of BCBSM’s Value Partnerships, which works with physician organizations and hospitals to improve patient care and provide value to members and customers.

The PCMH program isn’t a 50/50 co-branded joint venture like Banner | Aetna, but is an example of a less intensive partnership looking to have a similar result. The PCMH started nine years ago and includes 4,692 physicians in 1,709 practices. There are PCMH practices in 81 of Michigan’s 83 counties.

The idea of a PCMH began a decade ago as a way to improve care and outcomes while cutting costs. The model has primary care physicians leading care teams, which include specialists, that focus on each patient by tracking conditions and making sure patients get care “at the appropriate time and in the most appropriate setting,” according to BCBSM.

The payer said they have seen success. This year, PCMH practices are performing better than other practices. Blue Cross Blue Shield of Michigan said PCMH practices have seen 19% lower rate of emergency room (ER) visits for adults; 23% lower rate for primary care sensitive ER visits for adults; 25% lower rate of ambulatory care sensitive inpatient stays for adults and 15% lower rate of pediatric ER visits.

“If we keep the customer — the end user — in mind and build partnerships with that as our North Star, we believe we will have a more successful, efficient and collaborative health system.” Tom Grote CEO of Banner | Aetna joint venture

A recent Health Services Research report also found that hospital per-member per-month cost was reduced by 17.2% and emergency department per-member per-month cost was reduced by 9.4% for Blue Cross PCMH patients with asthma, angina, diabetes, chronic obstructive pulmonary disease, high blood pressure and congestive heart failure.

Tom Leyden, director II of the Value Partnerships Program at BCBSM, told Healthcare Dive members actively engaged with their primary care physicians are seeing better outcomes. What’s made the BCBSM program a success is “strong relationships that have been cultivated within the Michigan healthcare community,” he said.

Leyden said providers want to be active participants in system transformation.

“This requires ongoing support from the payer and demonstrated evidence of practice transformation and clinic results from the provider community,” said Leyden. “Administration of these programs is an integral aspect of measuring performance.”

Leyden said the payer strives to make the programs as manageable as possible because physicians need to perform many administrative tasks on an ongoing basis. BCBSM regularly solicits feedback from providers during quarterly meetings and phone calls, emails, webinars and in-person meetings on what’s working, what’s not and what needs to be changed.

Barriers to overcome

One barrier that still needs resolution in partnerships is moving providers away from phone communication. Availity recently published a survey of 40 health plans and more than 400 practice- and facility-based providers that found respondents said phone communication is the preferred way for providers to communicate with payers.

Leatherwood said a more efficient way is a queue system. In this system, a provider could check the status of all claims and get alerts when they need to provide more information. The system would allow providers to look in one queue, update the claims information and then move on with their day. Payers would have their own queue and would get alerts when providers have questions. This would reduce phone calls and create immediacy.

Leatherwood said the healthcare system is stuck in a “chart chase” between providers and payers, and moving to an automated queue system would be a gamechanger.

Another big question is whether partnerships can scale. Expanding these partnerships beyond local or state boundaries may be difficult. Grote said partnerships are intensive and require close relationships, so joint ventures work best on a regional or state level.

It’s still too early in the process to say how partnerships will morph down the road. There are many different types of partnerships and more are likely to develop depending on locations, providers, payers and needs.

“I think in the near-term what we’re going to see is larger healthcare providers are going to be more strategic, working directly with payers. The health plans are going to be more interested not just in working with the staff level, but executive levels,” said Leatherwood.

Output: Payers and providers have for decades stayed in their silos, leading to a more fractured and adversarial healthcare system. That relationship, however, is starting to soften for many in the industry. Payer-provider partnerships put the two groups on the same team in hopes of reducing costs and improving care and outcomes through sharing data and better communication.


Instruction: create a high quality summary of the given input

Input:
High intensity interval training can reverse frailty at advanced age, preclinical study finds
 Credit: University at Buffalo

Growing older may not have to mean growing frail. A preclinical study has revealed that brief periods of intense physical activity can be safely administered at advanced age, and that this kind of activity has the potential to reverse frailty.

Published in the Journal of Gerontology A in June by University at Buffalo researchers, the study is the first to investigate whether a novel, short-session regimen of high-intensity interval training (HIIT) can be safe and effective in older populations.

The study was conducted on two groups of a dozen mice, each 24 months old, which correlates roughly to 65 years old in human terms. All the mice had been sedentary up until that age. While cautioning that the study was done in mice, the authors state that the results could have significant application to humans.

"We know that being frail or being at risk for becoming frail puts people at increased risk of dying and comorbidity," said Bruce R. Troen, MD, senior author on the study with Kenneth L. Seldeen, PhD, who is first author.

Troen is professor and chief of the Division of Geriatrics and Palliative Medicine in the Department of Medicine, Jacobs School of Medicine and Biomedical Sciences at UB, a geriatrician with UBMD Internal Medicine, and a physician-investigator with the Veterans Affairs Western New York Health Care System. Seldeen is research assistant professor of medicine at UB.

"These results show that it's possible that high-intensity interval training can help enhance quality of life and capacity to be healthy," Troen said.

The results were striking with mice exhibiting "dramatic" improvements in numerous measurements, including strength and physical performance.

No longer frail

One of the most significant findings was that by the end of the study, five of six mice found to be frail or pre-frail at baseline improved, and four were no longer frail.

"Those four mice who had exhibited the kinds of deficits that correlate to frailty in humans improved to a completely robust level," said Troen. "The HIIT actually reversed frailty in them."

Troen and Seldeen developed mouse equivalents for measures that assess human frailty, including ways to evaluate grip strength, endurance and gait speed, so that they could establish baseline levels and then compare those with results once the study was complete.

"Because the performance measures for the mice are directly relevant to clinical parameters, we think this program of exercise is quite applicable to humans," said Troen. "We're laying a foundation so we can do this in people and so we can understand how to tailor it to individuals so they can successfully implement this."

Similar to the way that an athletic trainer might individualize a fitness program for a client, Troen and Seldeen tailored intensity levels to each mouse.

"While the mice are genetically identical, they aren't phenotypically identical," Seldeen explained, "so we customized the exercise program to each mouse, first finding out what each one was capable of at baseline, and then increasing or decreasing the intensity depending on the performance of the mouse during the study."

HIIT was well-tolerated

The 10-minute exercise program involved a three-minute warm-up, three intervals of one minute of high intensity and one minute at lower intensity, and a final minute of higher intensity on an inclined treadmill. The exercises were done three times a week over 16 weeks. All exercises were well-tolerated by the mice.

There were dramatic improvements in grip strength, treadmill endurance and gait speed. The mice showed greater muscle mass and an increase in total mitochondria, the energy factories of cells.

"Increased mitochondrial biomass allows you to utilize oxygen more efficiency," Troen explained. "With HIIT, we saw both mitochondrial increase and an improvement in muscle quality and fiber size in these mice."

As to why HIIT results in such significant benefits to those who engage in it, Troen said that it has to do with the stress to which it subjects the body.

"Exercise stresses the system and the body can respond beneficially," he explained. "We believe that the intensity of individualized HIIT provides a more significant but manageable stress so the body responds more robustly to these short, vigorous periods of exercise.

"In other words, you get more bang for your buck."

Troen and Seldeen cautioned that anyone considering HIIT should check with their physician first.

Output: Growing older may not have to mean growing frail. A preclinical study has revealed that brief periods of intense physical activity can be safely administered at advanced age, and that this kind of activity has the potential to reverse frailty.


Instruction: create a high quality summary of the given input

Input:
Social isolation, loneliness could be greater threat to public health than obesity, researchers say
 Credit: CC0 Public Domain

Loneliness and social isolation may represent a greater public health hazard than obesity, and their impact has been growing and will continue to grow, according to research presented at the 125th Annual Convention of the American Psychological Association.

"Being connected to others socially is widely considered a fundamental human need—crucial to both well-being and survival. Extreme examples show infants in custodial care who lack human contact fail to thrive and often die, and indeed, social isolation or solitary confinement has been used as a form of punishment," said Julianne Holt-Lunstad, PhD, professor of psychology at Brigham Young University. "Yet an increasing portion of the U.S. population now experiences isolation regularly."

Approximately 42.6 million adults over age 45 in the United States are estimated to be suffering from chronic loneliness, according to AARP's Loneliness Study. In addition, the most recent U.S. census data shows more than a quarter of the population lives alone, more than half of the population is unmarried and, since the previous census, marriage rates and the number of children per household have declined.

"These trends suggest that Americans are becoming less socially connected and experiencing more loneliness," said Holt-Lunstad.

To illustrate the influence of social isolation and loneliness on the risk for premature mortality, Holt-Lunstad presented data from two meta-analyses. The first involved 148 studies, representing more than 300,000 participants, and found that greater social connection is associated with a 50 percent reduced risk of early death. The second study, involving 70 studies representing more than 3.4 million individuals primarily from North America but also from Europe, Asia and Australia, examined the role that social isolation, loneliness or living alone might have on mortality. Researchers found that all three had a significant and equal effect on the risk of premature death, one that was equal to or exceeded the effect of other well-accepted risk factors such as obesity.

"There is robust evidence that social isolation and loneliness significantly increase risk for premature mortality, and the magnitude of the risk exceeds that of many leading health indicators," said Holt-Lunstad. "With an increasing aging population, the effect on public health is only anticipated to increase. Indeed, many nations around the world now suggest we are facing a 'loneliness epidemic.' The challenge we face now is what can be done about it."

Holt-Lunstad recommended a greater priority be placed on research and resources to tackle this public health threat from the societal to the individual level. For instance, greater emphasis could be placed on social skills training for children in schools and doctors should be encouraged to include social connectedness in medical screening, she said. Additionally, people should be preparing for retirement socially as well as financially, as many social ties are related to the workplace, she noted, adding that community planners should make sure to include shared social spaces that encourage gathering and interaction, such as recreation centers and community gardens.

More information: Session 3328: "Loneliness: A Growing Public Health Threat," Plenary, Saturday, Aug. 5, 3-3:50 p.m. EDT, Room 151A, Street Level, Walter E. Washington Convention Center, 801 Mount Vernon Pl., N.W., Washington, D.C.

Output: Loneliness and social isolation may represent a greater public health hazard than obesity, and their impact has been growing and will continue to grow, according to research presented at the 125th Annual Convention of the American Psychological Association.


Instruction: create a high quality summary of the given input

Input:
Caregiving Is Hard Enough. Isolation Can Make It Unbearable.
 “I was dumbfounded,” Ms. Sherman-Lewis said. “It’s O.K. for other people’s little grandchildren to be running around sometimes. What am I supposed to do, keep him in a crate in the car?”

Like so many caregivers, she has discovered that along with the abandoned career, the hands-on tasks, the medical scheduling, the insurance tussles and the disrupted sleep, she faces another trial: social isolation.

“It’s hurtful,” she said. “You need friends more than ever.”

But where are they? Betsey Brairton, 48, cares for her mother, Sue, in rural Olean, N.Y. The elder Ms. Brairton, 79, suffers from spinal stenosis, arthritis and lingering damage from a stroke, so she has limited mobility. “We hardly go anywhere, and nobody comes here,” said her daughter. When she does leave for an hour or two, she’s afraid to put down her cellphone.

Though a couple of friends occasionally invite her out for dinner, “I can’t commit to anything, in case my mom is having a bad day,” Ms. Brairton said. She has begun to worry that when she does spend time with others, her narrowing life leaves her with nothing interesting to say.

Those who work with caregivers know this phenomenon well, especially when the cared-for person has dementia, a particularly arduous responsibility.

Output: For years, Marcy Sherman-Lewis went to a beauty salon in St. Joseph, Mo., every few weeks for a haircut and highlights. It had become something of an ordeal to prepare her husband, Gene Lewis, for this outing; he has Alzheimer’s disease, at 79, and helping him shower and dress, insert hearing aids and climb into the car was a very slow process.


Instruction: create a high quality summary of the given input

Input:
Why robots are the way of our aging future
 This piece originally appeared in New America Media Elizabeth Payne wrote this article for Canada’s Ottawa Citizen with the support of a journalism fellowship from New America Media, The Gerontological Society of America and the Silver Century Foundation .

SAN FRANCISCO — Paro closes its watery eyes, tilts its head and emits a soft cry. The robotic harp seal — the world’s best-known therapeutic robot — is the creation of Japanese scientist Takanori Shibata, but its voice is made in Canada. Shibata recorded the baby harp seal, which became the voice of Paro, on Quebec’s Magdalen Islands.

“It’s a Canadian seal,” said Shibata, who showed off his cuddly creation at the world’s largest gathering of experts in the field of aging this week in San Francisco.

Paro, now used to help dementia patients and others in 30 countries around the world, is a huggable face of the high-tech future of aging. The burgeoning field is known as gerontechnology.

Eases stress for dementia patients

Paro, which has been used in Japan and through Europe since 2003, has helped demonstrate that technology can be used and embraced in previously-unheard-of ways for eldercare. The robot seal, which responds to touch and makes eye contact, has been found to reduce patient and caregiver stress, to stimulate interaction between patients and caregivers and to improve the socialization of patients. It has also been found to reduce the need for medication in some cases.

It’s not all as warm and fuzzy as Paro, but technology — from smart homes, to health monitoring devices, to virtual reality therapy, to autonomous transportation, to technological advancements not yet dreamed of — are all part of the future of aging, according to experts.

Held in San Francisco, the World Congress of Gerontology and Geriatrics, devoted an entire day this week to technology, a first for the gathering. It came complete with a “startup alley” and pitch competition designed to bring the worlds of academia and startups together. Among pitches: a virtual reality program designed to bring a little bit of the outdoors to the institution-bound elders.

Technological advances have made many new aging technologies possible, said William Kearns, president of the International Society for Gerontechnology. Robots have a particular appeal.

“A robot can be a far more persuasive way to get a person to behave in a certain way — such as exercising — than an iPad or a cellphone,” Kearns said.

Canada’s federally funded aging and technology network, AGE-WELL (Aging Gracefully across Environments using Technology to Support Wellness, Engagement and Long Life), helped organize the event among a range of universities and organizations in North America.

Andrew Sixsmith, scientific director of AGE-WELL, said Canada is becoming a world leader in the field.

“The Canadian government has had the foresight to invest in this sector because they realize there is an aging population, and we need solutions that are going to address the challenges and the opportunities that brings,” he said.

“We are very keen in terms of the real-world impact of what we want to do, but also to demonstrate to the rest of the world that Canada can take a lead in this. I think Canada has put a lot of effort and investment into this and, down the line, that is going to pay off in terms of how it can benefit Canadian research, Canadian older people, the Canadian economy, but also benefit the rest of the world as well.”

Improving overall wellbeing

Joseph Coughlin, founder of AgeLab at MIT, predicted smart homes, robots and more will change the way people live and age.

“It is not about reminding me to take my meds, it is about having overall wellbeing and enabling me to do things, to improve the quality of life, not simply to extend it,” he said. “We should understand we are designing a lifestyle.”

Coughlin predicted the coming generation of elderly will demand technology to help support them and enhance their lives.

“Are you going to be as polite as your parents?” he asked. “No, you are going to expect a pill, a product or a policy to insure you live longer better because you have seen it your whole life.”

Along with potential, the field of gerontechnology comes with challenges: Among them, the ethical issues of increased surveillance on the elderly and the fear that technology will replace the need for human interaction.

Sixsmith talked about the need for further study about the implications of increased surveillance of the elderly — particularly in their own homes.

“The home environment has always been the domain in the individual, the space where you can be free from the observation of others. The introduction of surveillance technology breaks that boundary, and this is significant,” he stated.

Beyond nanny cams installed by concerned family members to watch elders is a future in which implanted tracking devices become more common. That raises new questions, said Coughlin.

Coughlin asked, “Where is privacy and dignity in all of this? How far do I push your dignity in order to ensure your safety? The new question is going to be: To chip or not to chip?”

Output: Paro closes its watery eyes, tilts its head and emits a soft cry. The robotic harp seal — the world’s best-known therapeutic robot — is the creation of Japanese scientist Takanori Shibata, but its voice is made in Canada. Shibata recorded the baby harp seal, which became the voice of Paro, on Quebec’s Magdalen Islands.


Instruction: create a high quality summary of the given input

Input:
Older women are in worse financial shape than before, data says
 Maurie Backman

The Motley Fool

Though the fact that women typically earn less money than men has always spelled trouble on the retirement front, recent data reveals that most women don't have the knowledge necessary to make long-term financial decisions. Specifically, only 18% of retirement-age women could pass a basic quiz on planning for the future, whereas 35% of men could do the same.

But that's not the only negative piece of data on women and retirement to come out lately. According to new research from the George Washington University Global Financial Literacy Excellence Center, women in their 50s are more financially fragile today than they were a generation ago. Not only has debt doubled for women in their 50s since the early 1990s, but twice as many 50-something females have less than $25,000 in savings. And that's a real problem, because women who are already in their 50s are generally looking at just 10 to 15 years to eliminate debt before retirement and catch up on building a nest egg. When we throw in the fact that women tend to live longer than men, and therefore require more savings, it becomes all the more critical for older female workers to clean up their finances while they still have an opportunity to do so.

Why older women struggle to save

It stands to reason that the less money you earn, the less you'll have available to save. Now the wage gap numbers (meaning, the extent to which men out-earn women) tend to bounce around from year to year, but generally speaking, women are said to earn anywhere from $0.77 to $0.83 for every dollar taken in by their comparably qualified male counterparts. This means that even if they save the same amount of their salaries percentage-wise, they're still apt to lag behind men. It's no wonder, then, that women typically have less money available during retirement.

Furthermore, because women earn less, it's difficult for them to pay off debt once they incur it. And new data tells us that females' debt problems may begin as early as college, with women borrowing $3,100 more, on average, than men to finance an education. As such, it takes women almost two years longer, on average, to repay their student loans.

The bad news in all of this, obviously, is that the above research spells trouble for women on many fronts. The good news, however, is that women have options for overcoming the obstacles they face and improving their finances, both now and in the future.

A proactive approach to a healthy financial future

Despite their lack of retirement-planning knowledge, women are generally good investors, and a lot of that boils down to their tendency to ask questions, be patient, and take a disciplined approach to building wealth. That said, it's clear that women still have some catching up to do -- especially those in their 50s who have yet to amass $25,000 for retirement. If you're one of them, your best move is to ramp up your savings rate immediately and get as much cash into your IRA or 401(k) as possible.

If you're 50 or older, you can contribute up to $6,500 a year to the former and a rather generous $24,000 a year to the latter. Even if you can't max out either of these limits, saving $5,000 a year for 15 years will give you an additional $108,000 to work with in retirement, assuming your investments are able to generate a relatively conservative average annual 5% return during that decade and a half.

Furthermore, if you're offered a 401(k) through your job, increasing your savings rate will help ensure that you're able to capitalize on whatever matching incentive your employer offers. And that's an easy way to snag some extra cash for the future.

At the same time, you'll want to work on knocking out debt (especially the non-mortgage kind) so that those payments cease to hang over your head once retirement rolls around. If your current income doesn't allow you to rapidly rid yourself of debt, it pays to consider a side job. Another option, of course, is to cut back on certain living expenses to free up that cash, whether it's downsizing your home or forgoing certain luxuries for a couple of years, like cable or restaurant meals.

No matter what steps you take to save more and owe less, the key is to act while you still have some time left on your side. It's your best hope for retiring on time and not struggling financially during your senior years.

The Motley Fool has a disclosure policy.

The Motley Fool is a USA TODAY content partner offering financial news, analysis and commentary designed to help people take control of their financial lives. Its content is produced independently of USA TODAY.

Offer from the Motley Fool:The $16,122 Social Security bonus most retirees completely overlook

If you're like most Americans, you're a few years (or more) behind on your retirement savings. But a handful of little-known "Social Security secrets" could help ensure a boost in your retirement income. For example: one easy trick could pay you as much as $16,122 more... each year! Once you learn how to maximize your Social Security benefits, we think you could retire confidently with the peace of mind we're all after. Simply click here to discover how to learn more about these strategies.

Output: Though the fact that women typically earn less money than men has always spelled trouble on the retirement front, recent data reveals that most women don't have the knowledge necessary to make long-term financial decisions. Specifically, only 18% of retirement-age women could pass a basic quiz on planning for the future, whereas 35% of men could do the same.


Instruction: create a high quality summary of the given input

Input:
Chinese surgeons successfully implant 3D-printed sternum in boy
 Aug 7, 2017 | By Tess

A team of doctors from the Shanghai Children’s Medical Center in China have successfully implanted a 3D printed sternum shell into a six-year-old boy with a rare congenital problem. The medical center is affiliated with the School of Medicine at the Shanghai Jiao Tong University.

Abu, a six-year-old from China’s XinJiang province was born with a rare congenital malformation of his sternum which caused his heart to essentially hang in his abdominal cavity. The serious condition, which can be seen from looking at the child’s chest, led doctors to believe that Abu would only live to the age of two.

Six years later, however, Abu is still alive, though he does face his share of hardships. To keep him safe, his mother has kept him from activities that most children partake in, such as sports and games. His delicate condition has also prevented him from going to school.

Last month, Abu’s case was brought to Dr. Zhang Lei from the Shanghai Children’s Medical Center, who, with a dedicated team from Zepu County and the Kashi Second Hospital, made a plan to treat and save the young child.

On July 17th, Abu and his mother arrived at the Shanghai Children’s Medical Center for a consultation with a team of cardiothoracic, cardiovascular, and cerebrovascular disease specialists. The team discovered that Abu was suffering from five different deformities, making his case one of the rarest congenital malformations they had ever seen and one of the rarest in the world (with only about 200 cases reported).

In addition to his sternal defects, Abu also had an endocardial defect on the external portion of his heart, a right ventricle double outlet, a pulmonary valve stenosis, and a tricuspid regurgitation.

While the most ideal time to operate on someone with such a condition would be at a much younger age (between 1 and 2 years), the doctors believed there was hope for Abu as he demonstrated a stable situation with oxygen saturation of about 90%. The goal was to protect the child’s heart with a 3D printed sternum shell which would encage the external heart.

The 3D printed sternum shell was 3D printed from a biocompatible PEEK material and was designed specifically for Abu’s anatomy. According to the doctors, the material does not adhere to other organs and tissues easily, making it suitable for the procedure and for follow-up treatments.

The implantation was recently completed and the doctors say it was an overall success, though they will have to do regular follow ups with the young patient to keep tabs on his recovery. Abu is expected to begin school in the near future.

Posted in 3D Printing Application

Maybe you also like:

Output: Surgeons have transplanted a 3D-printed sternum into a six-year-old boy at Shanghai Children’s Medical Centre in China. The boy was suffering from one of the rarest congenital malformations in the world. The sternum shell was printed from a biocompatible PEEK material, which doctors said was suitable for the procedure and for follow-up treatments as it did not adhere to other organs. The patient, who was not expected to survive past his second birthday, will attend school for the first time in the near future.


Instruction: create a high quality summary of the given input

Input:
Google employee claims “biological causes” behind tech gender gap
 New York (AFP) –

Advertising Read more

Google found itself at the center of controversy Sunday after an employee in a leaked internal document claimed "biological causes" explained the lack of women in tech industry leadership roles.

The screed -- dubbed "sexist" by US media -- revived the simmering debate over a culture of sexism and lack of diversity in tech sectors.

"I'm simply stating that the distribution of preferences and abilities of men and women differ in part due to biological causes and that these differences may explain why we don't see equal representation of women in tech and leadership," read the 3,000-word fulmination by an anonymous male software engineer.

According to the author, natural aptitudes of men allow them to become better computer programmers. Women, he said, have more "openness directed towards feelings and aesthetics rather than ideas" -- meaning they "prefer jobs in social or artistic areas."

In response to the leaked memo, Danielle Brown, Google's new vice president of diversity, told employees in an email that "it's not a viewpoint that I or this company endorses, promotes or encourages".

"Changing a culture is hard, and it's often uncomfortable," she said.

Brown added, however, that "part of building an open, inclusive environment means fostering a culture in which those with alternative views, including different political views, feel safe sharing their opinions."

The controversy comes as increasing numbers of women are going public with complaints of gender-based discrimination in Silicon Valley.

Uber's embattled chief executive Travis Kalanick resigned earlier this year under pressure from investors seeking to clean up the company's allegedly toxic corporate culture.

His departure capped a rocky period for the global ridesharing giant, which has been roiled by disturbing reports of cutthroat workplace conditions, harassment and discrimination.

© 2017 AFP

Output: A Google employee has claimed that “biological causes” are responsible for the lack of women in leadership roles in the tech sector, according to a leaked internal document. The document, written by anonymous male software engineer, claims that men have a greater natural aptitude for computer programming, whereas women “prefer jobs in social or artistic areas”. Google’s new vice president of diversity, Danielle Brown, emailed employees, stating that such an opinion was “not a viewpoint that I or this company endorses, promotes or encourages". The leak follows a number of accusations by women of gender-discrimination in Silicon Valley.