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AmSurg proposes merger, TeamHealth rejects

AmSurg Corp proposed a $5.3 billion merger with TeamHealth Holdings Inc as it looks to add heft to its business that provides doctors to hospitals and other healthcare services.
AmSurg, which revealed on Tuesday that private merger talks with TeamHealth fell through in September, said it had gone public with the offer to persuade TeamHealth "to come back to the table".
TeamHealth, however, swiftly rejected the offer, saying it undervalued the company.
The cash-and-stock offer of $71.47 per share represents a premium of 36 percent to TeamHealth's closing price on Monday.
AmSurg expects that synergies from the combination could eventually be worth an additional $9 to $10 per share for stockholders, AmSurg CEO Christopher Holden said in an interview with Reuters.
TeamHealth shares were up about 14 percent at $60, while AmSurg was down 4 percent.
Some analysts said investors were worried that the high stock component in the offer could scuttle the deal.
"The initial offer is 22 percent cash and 78 percent stock…the comparatively high stock component makes the chances of a final deal lower than if the deal had a greater cash component," Wells Fargo analyst Gary Lieberman said in a note.
A deal would make the combination a leading provider of medical staff such as radiologists, anesthesiologists and physicians for ambulatory surgery and primary care, AmSurg said.
The companies have a combined network of 1,200 healthcare facilities and about 20,000 clinicians. The combined company, which would assume the TeamHealth name, would be led by AmSurg's Holden.
AmSurg also said it would back TeamHealth's acquisition of IPC Healthcare Inc for $1.4 billion.
AmSurg, which is known more for its ambulatory surgery centers, forayed into the outsourced physician market with the acquisition of Sheridan Healthcare Inc in 2014.
More than half the company's total revenue in the quarter ended June came from the physician services business.
The total enterprise value of the deal is $7.8 billion, AmSurg said.
The U.S. healthcare sector is rapidly consolidating as pharmaceutical companies, drug retailers, health insurers and hospital systems are looking to bulk up to better negotiate with each other. Health insurers, in particular, want to be able to negotiate better prices with doctors and hospitals.
"Physicians are seeking a platform that offers them a voice in this rapidly consolidating market," Holden said on a conference call with analysts.
In the interview with Reuters, Holden said AmSurg was confident that its proposed combination would not raise the ire of anti-trust regulators. He noted that the marketplace for its services was highly fragmented and there was minimal overlap between AmSurg and TeamHealth.
Guggenheim Securities and J.P. Morgan Securities LLC are financial advisers and Bass, Berry & Sims PLC is legal counsel to AmSurg. Citi is serving as financial advisor to TeamHealth, and Simpson Thacher & Bartlett LLP is serving as its legal counsel.

PinnacleHealth collaborates with Cigna to improve Health and Lower Costs in Harrisburg

Cigna (CI) has launched a collaborative care initiative with PinnacleHealth in central Pennsylvania. The aim of the program is to improve patient access to health care, enhance care coordination, and achieve the goal of improved health, affordability and patient experience. Cigna Collaborative Care is the company’s approach to accomplishing the same population health goals as accountable care organizations, or ACOs.
In places where it’s been introduced, Cigna Collaborative Care is helping to improve the health of Cigna customers while effectively managing medical costs. The programs are helping to close gaps in care, 
such as missed health screenings or prescription refills, reinforcing the appropriate use of hospital emergency rooms, increasing the number of preventive health visits and improving follow-up care for people transitioning from the hospital to home.
“Chronic disease incidence is one of the top challenges facing the U.S. healthcare system today. There are multiple factors that contribute to an individual’s health,” says Michael A. Young, president and CEO of PinnacleHealth. “By pursuing innovative partnerships and embracing new roles, we can identify and address the root causes of illness, provide the right care and solve problems that lead to poor health.”
“We need a patient-centered health care delivery system that emphasizes prevention and primary care and rewards health care professionals for quality of care and improved health outcomes,” said Julia Huggins, Cigna president for Pennsylvania. “A system that’s focused on value rather than volume will ultimately lead to a healthier population and lower medical costs, which is good for individuals, families, employers and doctors.”
Under the program, PinnacleHealth physicians will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current doctor and automatically receive the benefits of the program. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a PinnacleHealth physician will also have access to the benefits of the program. There are no changes in any plan requirements regarding referrals to specialists. Patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes, heart disease and obesity.
Critical to the program’s benefits are the registered nurse clinical care coordinators, employed by PinnacleHealth, who will help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators are aligned with a team of Cigna case managers to ensure a high degree of collaboration between PinnacleHealth and Cigna, which will ultimately provide a better experience for the individual.
The care coordinators will enhance care by using patient-specific data from Cigna to help identify individuals who may be overdue for important health screenings or who may have skipped a prescription refill, as well as individuals who have had a recent emergency room visit. The care coordinators are part of physician-led care teams that will help people get the follow-up care or screenings they need, 
identify potential complications related to medications and help prevent chronic conditions from worsening.
Care coordinators can also help individuals schedule appointments, provide health education and refer people to Cigna's clinical support programs that are part of their employer’s health plan.
Cigna will compensate PinnacleHealth physicians for the medical and care coordination services they provide. Additionally, doctors may be rewarded through a “pay for value” structure for meeting targets for improving quality and lowering medical costs.
Cigna has been at the forefront of the accountable care organization movement since 2008 and now has 134 Cigna Collaborative Care arrangements with large physician groups that span 29 states, reach nearly 1.5 million commercial customers and encompass nearly 60,000 doctors, including approximately 30,000 primary care physicians and 30,000 specialists.

SV Life Sciences to manage $100 mln dementia research fund

The world's first fund focused on preventing and treating dementia was launched on Wednesday, backed by leading drug companies, with venture capital firm SV Life Sciences appointed as fund manager.
The $100 million Dementia Discovery Fund is unusual in focusing on a single difficult-to-treat disorder and in bringing together both industry and government.
The initiative was announced by British health minister Jeremy Hunt in March, following a Group of Eight nations conference in 2013 that set a goal of finding a cure or effective treatment for dementia by 2025.
The fund is backed by Biogen, GlaxoSmithKline , Johnson & Johnson, Eli Lilly, Pfizer and Takeda, along with the British government and Alzheimer's Research UK.
Dementia, of which Alzheimer's is the most common form, affects nearly 50 million people worldwide and the figure is set to reach 135 million by 2050, according to non-profit campaign group Alzheimer's Disease International.
There is still no treatment to slow its progression, with current drugs only easing some of the symptoms.
The fund will back promising research projects and drugmakers then wishing to develop particular ideas will be able to bid for rights, with money raised being reinvested in the fund.

Prime Healthcare Foundation signs definitive agreement to acquire River Valley Health Partners

River Valley Health Partners (RVHP) and Prime Healthcare Foundation have signed a definitive agreement for the acquisition of RVHP.
"The mission of the Prime Healthcare Foundation matches with the long term mission and vision of RVHP and we look forward to the future with great pride," said RVHP Board of Trustees Chairman Pete Wicks. The agreement includes a commitment from Prime to maintain inpatient services, strengthen physician recruitment, hire substantially all employees, and to provide a multimillion dollar capital commitment over the next five years.
"RVHP has provided high quality healthcare to the residents of East Liverpool for more than a century," said Prem Reddy, MD, FACC, FCCP, Chairman, President and CEO of Prime Healthcare Services. 
"Through our acquisition of RVHP, we look forward to partnering with physicians, nurses, employees and the community to preserve this invaluable healthcare institution for generations to come."
The acquisition is expected to close in the first quarter of 2016, pending regulatory review and closing conditions.
The Prime Healthcare Foundation is a non-profit hospital system that operates seven hospitals in California and Texas. It is affiliated with Prime Healthcare Services, an award-winning hospital system with 38 acute care hospitals providing more than 40,000 jobs in 11 states. Together, Prime Healthcare Services and the Prime Healthcare Foundation are dedicated to providing the best quality care to the communities they serve and have been recognized as among the "15 Top Health Systems" three times by Truven Health Analytics.

NeoGenomics to acquire GE Cancer Testing Unit Clarient

NeoGenomics Inc. agreed to acquire Clarient Inc., a subsidiary of the health-care unit of General Electric Co. , in a deal potentially valued at $275.2 million that aims to broaden the genetic-testing company’s offerings of cancer diagnostic tests.
Under the deal, NeoGenomics will acquire the cancer diagnostic testing firm for $80 million in cash, $110 million in preferred stock, and 15 million shares of NeoGenomics common stock—valued at roughly at $85.2 million based on Tuesday’s closing price.
NeoGenomics Chairman and Chief Executive Douglas VanOort said NeoGenomics and GE Healthcare have agreed to collaborate on a new bioinformatics initiative that will explore the potential for new products that combine genomic and imaging data.
Clarient had revenue of $127 million last year and has roughly 415 employees.
NeoGenomics said that Clarient’s capabilities in testing for solid tumor cancers of the breast, colon and lung are highly complementary to its capabilities in testing hematologic cancers.
The company expects cost savings of $4 million to $6 million next year, with annual cost savings rising to $20 million to $30 million by the end of the third year following the deal.

IGI Laboratories, Inc. announces name change to Teligent, Inc.

IGI Laboratories, Inc., a New Jersey-based specialty generic pharmaceutical company, announced that it will adopt Teligent, Inc. as its new name and will begin trading under a new symbol – TLGT – after ringing the NASDAQ Opening Bell on October 26, 2015.
''Our new name captures the energy and passion that our people feel about our future,'' said Jason Grenfell-Gardner, the Company's President and Chief Executive Officer. ''We are proud of what we have accomplished so far in our Company's transformation, and our people are energized by the opportunities that we see ahead of us.
''There are three pillars that shape the kind of company that we are building. First, we are driven by robust science. Second, we accept no middle ground when it comes to product quality. Finally, we believe in fostering a career of craftsmanship, where our people can become experts in their trade. Our new brand identity evolved from these three pillars, and they will continue to shape our future.''

Cohera Medical, Inc.® announces $50 Million in New Financing

Cohera Medical, a leading innovator and developer of absorbable surgical adhesives and sealants, announced closing the first tranche of a $50 million equity financing led by KKR, a leading global investment firm, with participation from existing private investors.
Cohera Medical has made significant strides in the last year, achieving FDA approval for its lead product, TissuGlu® Surgical Adhesive, as well as CE Marking in Europe for its second product, Sylys® Surgical Sealant. The Company will use the funds to launch U.S. commercial sales of TissuGlu, the first synthetic adhesive approved by the FDA for internal use. In addition, the Company intends to advance clinical trials for Sylys, an innovative surgical sealant under development for bowel repair with significant market potential.
"In clinical trials, surgeons were able to eliminate the need for post-surgical drains by using TissuGlu, reducing the need for invasive treatments for their abdominoplasty patients, and improving the patient recovery process. The Premarket Approval (PMA) supports the safety and effectiveness of TissuGlu as an alternative to the use of closed suction drains," said Patrick Daly, President and CEO of Cohera Medical. "We are excited to partner with KKR as we initiate commercialization of TissuGlu in the U.S. and believe that the Company's pipeline of products holds great promise for both patients and surgeons."
As part of the transaction, Ali Satvat, Director on KKR's health care investing team, will join the Company's Board of Directors. "We look forward to partnering with Patrick and his experienced team," said 
Mr. Satvat. "Cohera Medical has demonstrated an impressive ability to innovate transformational health care products and is at the forefront of new technologies in the expanding surgical adhesives and sealants market."
Cohera Medical recently received PMA approval for TissuGlu Surgical Adhesive indicated for the approximation of tissue planes in abdominoplasty procedures. Currently, most patients who undergo abdominoplasty procedures and other flap procedures require the insertion of drains to remove fluids that accumulate under the skin at the surgical site. TissuGlu adheres the tissue flap created during the procedure to the underlying tissue, helping to reduce the fluid that can accumulate in the space. In clinical trials, surgeons were able to eliminate the need for post-surgical drains in most abdominoplasty cases by using TissuGlu, reducing the need for invasive treatments for their abdominoplasty patients and improving the patients' ability to return to normal activities.
Cohera's product pipeline also includes Sylys, a resorbable synthetic sealant designed to help reduce anastomotic leakage in gastrointestinal procedures by providing additional support to the anastomosis during the first few days of healing, when the development of leaks is most likely to occur. Anastomotic leakage, which occurs in three to twenty-three percent of patients undergoing gastrointestinal surgery, is considered to be the most serious surgical complication encountered. The FDA has designated Sylys Surgical Sealant as an Expedited Access Pathway device due to its potential to address the unmet need related to gastrointestinal leaks.
For KKR, the investment is part of the firm's health care growth equity strategy, which is focused on high-growth companies for which KKR can be a unique partner in helping reach scale. KKR is funding the investment primarily from the balance sheet of KKR & Co. LP (NYSE:KKR).

HealthSouth’s Lakeshore Hospital plans $61.5M expansion project

HealthSouth Corp.'s Lakeshore Rehabilitation Hospital has filed plans with the State Health Planning and Development Agency for a major expansion project at the 42-year-old hospital.
The total cost of the two-stage expansion project, including first year annual operating costs, is $61.5 million.
According to the Certificate of Need filing, the first part of the project involves constructing a two-story, 20,220-square-foot addition to the existing facility that will include patient rooms, a nursing station, a day room and a lobby area.
HealthSouth (NYSE: HLS) said the second phase involves renovating 60 patient rooms across 51,100 square feet to meet the standards of the Americans with Disabilities Act.
Currently, the hospital has 20 private patient rooms and 40 semiprivate rooms, but once the project is finished, which is anticipated for the first quarter of 2019, the hospital will have 64 private rooms and 18 semiprivate rooms.
The project will not add any additional beds to the facility's current count of 100, but will change the distribution of beds from 20 private beds and 80 semiprivate beds to 64 private beds and 36 semiprivate beds.
Along with updating the rooms to comply with the ADA, other reasons listed for the expansion include correcting inefficiencies in the delivery of private care, reducing the denials of admissions due to capacity constraints and repairing the infrastructure of the building.
HealthSouth has been expanding rapidly in recent months with several acquisitions and joint ventures outside the state. In the past, company leaders have said Alabama's Certificate of Need process has made expansion efforts difficult within the state.

Fresenius Medical Care buys dialysis specialist Nephromor

Kidney dialysis specialist Fresenius Medical Care is buying Israel-based peer Nephromor for about 350 million shekels ($90.23 million), German business paper Frankfurter Allgemeine Zeitung reported on Friday, citing industry sources.
Through the acquisition, FMC, which is not yet active in Israel, would become one of the leading providers of dialysis services in the country, the newspaper said.
"I can confirm that FMC has signed an agreement to take over dialysis centres in Israel. This is still subject to approval by the cartel authorities in Israel," a spokesman for the company told the newspaper, declining to say how much it would pay.
FMC was not available for immediate comment.

University Hospitals to build $32.4 million health center in North Ridgeville

A new addition is on the way to the bustling health care market of Lorain County.
University Hospitals on Thursday, Oct. 22, announced it plans to build a $32.4 million outpatient health center and freestanding emergency department in North Ridgeville. Construction will start later this year, and the facility is expected to be completed in 2017. A spokeswoman for UH said it’s too early to pinpoint the opening date or to discuss staffing levels at the center.
The proposed 50,300-square-foot center will sit on a 30-acre site on the north side of Lorain Road, just east of the entrance to the Ohio Turnpike. The site is visible from I-480 and I-80/Ohio Turnpike, and it can be accessed from state Route 10.
Dr. Donald Sheldon, president of UH Community Hospitals West Region, said in a news release that the new health center “will allow us to meet the increased demand for outpatient services and provide primary and specialty care in the communities surrounding UH Elyria Medical Center and St. John Medical Center.”
Designs for the facility still are being finalized. UH said initial plans include a freestanding emergency department, outpatient laboratory services, and physical therapy, primary and specialty care physician services.
Services will include UH Rainbow Babies & Children’s Hospital pediatric services, heart & vascular, orthopedics, pain management, general surgery, and rehabilitation, UH said.
The emergency department will be operational 24 hours per day, 365 days per year. It will be “fully integrated medically and operationally with the UH system and provide leading-edge technology and imaging,” UH said.
Lorain County is a hot market for health care these days.
Cleveland Clinic in 2011 opened the 190,000-square-foot Richard E. Jacobs Health Center in Avon, and it’s building a $143 million inpatient hospital in that city.
UH, meanwhile, rolled EMH Healthcare in Elyria into its enterprise in 2014, and the University Hospitals Rehabilitation Hospital in Avon, a 50-bed, 55,000-square-foot facility, is scheduled to open in 2016.
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