Chairman's Corner

Chairman David D. Halbert shares his thoughts about health improvement, healthcare policy, and technological innovation.

Caris Cares
May 17

The American Healthcare System is broken!  Payors are put in a position to force their policy holders (patients) to access the cheapest healthcare provider possible and to deny care entirely whenever they can get away with it.  But it’s not their fault.  It is the system that we, the American citizens, have put them in.  They are, for the most part, for-profit companies with a fiduciary duty to their shareholders to maximize profits.  Once they have set their premium for the insured the only way that they can make money is to keep what they call their “medical loss ratio” below their premium income.  So their only incentive is to steer you, the patient, to the cheapest possible healthcare provider.  Which flies in the face of what we all want, which is the highest quality care that we can possibly get for what ails us.

So now that puts the health care provider in a pickle!  Because the insurance companies won’t pay them unless they discount their services; regardless of the quality of care provided.  Further, they are paid for procedures performed on you, based on a system known as Current Procedural Terminology, or what they call CPT’s. Not based in any part on the quality of care or the outcome for the patient.  Again this is not their fault!  It is the system that we have put them in.  So they have to perform as many procedures as they can on their patients, at again steeply discounted prices, in order to get paid for them so they can pay their bills and the salaries of those people that work for them, including a large staff of administrative and billing people, in order to force the insurance companies to pay them.  Again, remember that these insurance companies don’t want to pay and they certainly don’t want to pay in a timely fashion.

What a horrible system that we have set up in this country!  Especially when one realizes that higher quality care actually saves the most money!  Think about it.  If you can diagnose someone accurately the first time and then get them on the right treatment, then they will get well faster and stay out of the system.  Meaning fewer doctor visits and fewer hospital visits because they are getting well.  This is a long-held perspective of mine which I call “Health Improvement.”  It is something that I feel very passionate about and have decided to devote the rest of my life to.

It is not an easy task.  The insurance companies are large and powerful.  The system has great momentum.  We here at Caris Life Sciences want to focus on quality first and have pulled together some of the world’s best doctors and scientists to be able to provide the best care that could possibly be offered to our patients.  We have attracted some of the top doctors that previously held professorships at the world’s leading institutions such as Johns Hopkins, Harvard, Cleveland Clinic, Mayo, University of Michigan, and UT Southwestern to name a few. There is no way that this could ever be accomplished in a not-for-profit setting.  Not with all the bureaucracies that exist in large siloed academic institutions.  We are a private company with a majority owner that is committed to long-term investment in bringing better quality care through better diagnostics for patients. Although we ultimately are a “for-profit” company, we have a vastly different agenda than other for-profit companies with accountability to a different ownership structure.  This creates a very unique situation that I do not believe has ever occurred before.

This is one of the reasons that we keep saying that we are a completely different kind of company because we have a completely different agenda!  Go ahead; take a look at our list of doctors and scientists.  Look at their backgrounds and training. Look at our molecular profiling that we do for cancer patients. We don’t know of anyone else in the world that offers anything like it.  Look at the research the Caris Research Institute publishes every year. All funded entirely by us with no outside money or grants of any kind.  Moreover, we have spent years now researching and developing a new platform technology that will revolutionize medicine.  We call it our Carisome technology.

It will create the opportunity to diagnose health conditions with precision from a simple blood test.  I focused on this because I believe that precise diagnoses will lead to much better care for the patient and also avoid costly, unnecessary procedures.  As an example, our first test that we will launch later this year is for prostate cancer.  The existing test today for prostate cancer is called the PSA test and it is not a very accurate test.  Proven by the fact that 70% of all prostate biopsies done in men with elevated PSA’s are not cancerous.  This is very costly to the system, but even worse many men become incontinent and impotent for at least some period of time following the biopsy, and some men even die from it. To quote Dr. Steve Gutman, the former head of the department at the FDA that approved the PSA test, “If you look at PSA which we approved for screening in 93, 94 or something like that; it’s now fourteen, fifteen years later we don’t even know if it saves lives or just makes people impotent and incontinent.” It is easy to see that if we had a blood test that could tell you with 95% accuracy that you don’t have cancer, then you don’t need the biopsy.  Thereby avoiding a very costly and invasive procedure.

Thanks to President Obama we now have a chance for the first time to begin crafting a new system built around you, the patient!  You must let your voices be heard by your doctors: Do not let them stop referring your samples to us just because the payors want them to refer your case to a cheaper option, which will often be a generalist who is not specialty-trained to read the area of concern.  And please tell your doctor to not set up his or her own lab to self-refer to a generalist and not specialists like we have here at Caris.  We provide specialty-trained or board certified pathologists and scientists to review and provide an expert opinion on every case sent to us. For every difficult biopsy we receive each day, there will be a grand-rounds session with over 20 experts evaluating and discussing it together to get to the absolute correct diagnosis. For this level of quality, we must hire the top doctors and scientists available; therefore we can’t afford to receive the bottom-rung reimbursement levels that many payors want us to accept. And by the way, this is short-sightedness on their behalf because with better diagnoses first we will help the patients get well faster, and ultimately take costs out of the system saving them money.

We will never compromise on our principle to deliver the highest quality care possible no matter what the cost!  We are now and forever committed to you the patient and believe that this is the only way to effectively change the system.  We are taking one step and one patient at a time because Caris Cares, and you are the only ones that can change this crazy system.  You only have the one life!  Let’s fight together and save as many lives as we can and relieve the most suffering possible!

Caris Cares!

The Caris Answer
Apr 14

There has been a lot of discussion lately concerning the value of diagnostic screening for cancer, especially the PSA test for prostate and mammography for breast cancer. In March, the New York Times quoted Richard Albin, Ph.D. calling the PSA test a "hugely expensive public health disaster." At an annual cost of over US$3 billion, he's right. The test is based on his discovery, and even he says it's "hardly more effective than a coin toss." And mammography -- considered an annual ritual for women over 40 -- caused quite a media stir late last year when the United States Preventive Service Task Force stated the test should now not be undertaken until age 50.

These debates center on the value of such screens to general public health as opposed to the value to the individual patient.  Meaning, do these screening tests contribute to a considerable number of lives saved or longer lives? And if so, at what cost?   If you were a man with prostate cancer or a woman with breast cancer, wouldn't you want to know that you have it regardless of the overall value from a health policy perspective?
 
So, the issue is not whether there is value to screening for early detection of cancer.  It's widely known that early detection can save lives that might otherwise be lost if the cancer is not detected until later stages.  The actual issue is the need for highly accurate diagnostics for cancer detection and monitoring.  Simply put, we need better tests.

Here at Caris, we are aware of this critical need and have been working hard on a new blood-based technology that will do just that - provide highly accurate early diagnosis of multiple forms of cancer - and all from a simple blood test!  We have been working diligently on this technology and are actively engaged with some of the finest medical institutions in the world to further validate it, so that we can bring these important diagnostic tests to patients who desperately need them as soon as possible. 
 
We couldn't be more excited about this transformative technology and the benefit that it will bring to patients around the globe.  But the benefit goes beyond early detection and monitoring of cancer.  We believe that we will be able to tell - again, with very high levels of accuracy - what stage the cancer is in and whether it's an aggressive form or a not so aggressive form.  And we believe that when patients and their physicians know a cancer's stage and nature, treatment can be customized to optimize both survival rates AND healthcare costs.   

We further believe that we will be able to validate our new technology's ability to determine whether or not a patient is responding to a specific drug or other treatment option very early.  This will demonstrate to the physician, in the early stages of disease, which treatment options are working and which are not - facilitating personalized treatment for the patient. 

We will begin launching the first in a series of tests utilizing this innovative technological platform later this year after we conclude our expanded validation efforts.  I just wanted to give you a heads up that new and exciting things are coming down the pike that will change the way medicine is practiced.  AND Caris will be at the very center, so stay tuned!

The Caris Vision
Mar 15

Welcome to the Chairman’s Corner and the new Caris Life Sciences™ website. It’s an exciting, transformative time in healthcare. Technological advances are creating the opportunity for a new company to emerge, one that will usher in an era of improved health through the use of precision healthcare. Caris Life Sciences is that company. We are using revolutionary new technologies to create highly accurate diagnostics and theranostics. As a result, patients will know the exact details of their illnesses and physicians will know precisely the best treatment options. We recently changed our name to Caris Life Sciences to reflect the multi-faceted, broad-based organization that we’ve become.

I started this Chairman’s Corner in order to share my vision about our organization and our direction. Caris is focused on the concept of what I call ‘health improvement’. Our philosophy is simple - by combining innovative technologies and the highest-quality services, healthcare will be improved and overall costs will then be reduced. Lower cost and quality are not at odds with each other. By providing the right diagnosis at an early stage, patients can receive the right treatments and get well faster, thereby avoiding expensive additional care.

Caris is advancing a new class of precision innovations in healthcare. We are poised to launch a series of blood-based diagnostics using a proprietary platform that is truly revolutionary. Through the use of this technology, physicians will be able to diagnose patients at earlier stages of disease and, in many cases, treat with less-invasive procedures and fewer side effects – all through simple blood tests. Stay tuned for more details in the near future.

Another Caris precision innovation is our Target Now portfolio of cancer tests. Target Now tests inform treating physicians about the possible therapeutic alternatives available to treat a patient’s unique tumor. Target Now starts by combing the latest clinical evidence to identify markers within tumor types. Then, advanced molecular profiling is performed to analyze and identify these markers within a patient’s specific tumor. Once the unique profile of the patient’s tumor is established, the Target Now evidence system compares the patient’s specific profile against the latest clinical evidence and lists the therapies that are most likely to be effective. Through the continued expansion of our Target Now portfolio and other ongoing initiatives, we are striving to become the ‘trusted guide’ for physicians, patients and payers as they navigate the complex landscape of cancer and the ever-changing information and evidence.

We can only achieve the “highest quality” by attracting and retaining doctors and scientists who are leaders in their fields. Our pathologists train at some of the best facilities in the nation, including Johns Hopkins, Harvard, Mayo Clinic, Cleveland Clinic and Duke. The company provides them with the best technology, ongoing education, and an intellectually-charged academic environment. Our pathologists focus their talents to find the right diagnosis from the onset, saving the patient from misdiagnoses and unnecessary treatments that are often painful and costly. The Caris quality commitment to find the right diagnosis the first time, every time, conserves healthcare resources and reduces costs for everyone.

Innovation, quality and commitment are also demonstrably apparent in our scientific leadership. Dr. George Poste and Dr. Jonathan Knowles bring a combination of world-renowned scientific expertise and business savvy that will contribute to Caris as we further establish ourselves as the leader in precision healthcare.

A final guiding principle that directs our actions on a daily basis is that Caris will never compromise our quality or ethics. We are tirelessly focused on becoming the ‘trusted intermediary’ for physicians and their patients. We recognize that we need to earn this trust each and every day through all of our actions. It is only through the highest integrity and the highest quality that we will be able to achieve our goal of helping as many people as possible.

In future Chairman’s Corners, I’ll share my thoughts about health improvement, healthcare policy, technological innovation, and many other topics. I hope you share my enthusiasm about our company, our progress and the opportunities that lie ahead in 2010 and beyond.