Fri.Jan 03, 2025

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Independent Health settles with Justice Department over alleged Medicare Advantage upcoding

Health Care Dive

The $100 million settlement is one of the larger recent sums agreed to by an MA payer accused of inflating its members’ sicknesses to get higher reimbursement from the government.

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In 2025, look for more digital-first patient engagement and data-driven decisions

Healthcare It News

Hospitals and health systems have been discussing digital-first patient engagement for a while now, but fewer organizations than you might think have made huge strides forward on that front. Likewise, data-driven decision-making is a phrase that's been tossed around quite a bit in healthcare, but in many cases it's a dream that's yet to become reality.

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HHS proposes HIPAA update to boost healthcare cybersecurity

Health Care Dive

The update, which would be the first since 2013, aims to clarify and provide more instruction on securing health data as cyberattacks and breaches in the sector skyrocket.

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Fierce Healthcare - Untitled Article

Fierce Healthcare

Mimicking prior federal and state investigations into drug manufacturers, health insurer Aetna is suing in Connecticut for rigging the generic drug market.

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From Diagnosis to Delivery: How AI is Revolutionizing the Patient Experience

Speaker: Simran Kaur, Founder & CEO at Tattva Health Inc.

The healthcare landscape is being revolutionized by AI and cutting-edge digital technologies, reshaping how patients receive care and interact with providers. In this webinar led by Simran Kaur, we will explore how AI-driven solutions are enhancing patient communication, improving care quality, and empowering preventive and predictive medicine. You'll also learn how AI is streamlining healthcare processes, helping providers offer more efficient, personalized care and enabling faster, data-driven

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States curb CON laws to boost bed capacity

Health Care Dive

The COVID-19 pandemic and population growth have led many states to scale back or eliminate Certificate of Need laws, which require providers to get regulatory approval before expanding or adding healthcare facilities.

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Fierce Healthcare - Untitled Article

Fierce Healthcare

Ardent Health is making good on its ambitions to grow its footprint in ambulatory care through acquisitions. The for-profit system kicked off 2025 by buying 18 urgent care clinics across New Mexico and Oklahoma from NextCare Urgent Care.

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Fierce Healthcare - Untitled Article

Fierce Healthcare

Providence is no longer in-network for Oregonians enrolled in Aetna plans amid lengthy contract negotiations between the two. | Providence is no longer in-network for Oregonians enrolled in Aetna plans amid lengthy contract negotiations between the two.

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Biden Signs Dole Act, Expanding Access And Funding For Vets’ At-Home Care

Home Health Care

Veterans will have expanded access to at-home care under a new law signed on Thursday by President Joe Biden. The National PACE Association (NPA) on Friday applauded Bidens signing of the Senator Elizabeth Dole 21 st Century Veterans Healthcare and Benefits Improvement Act, which will enhance veterans access to the Program of All-Inclusive Care for the Elderly (PACE) nationwide.

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Cold Comfort: The Latest Attacks on America Follow a Familiar Playbook

The Rand Blog

Recent vehicle attacks in New Orleans and Las Vegas underscore persistent terrorist threats in the United States. Both incidents, though likely unrelated, were premeditated and suggest political motives, raising public anxiety about safety and security.

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Home Recovery Care Plus Shows Value Of Hospital- And SNF-At-Home With Expanded Model

Home Health Care

Since launching five years ago, a partnership among Contessa, Highmark Health and Allegheny Health Network (AHN) has expanded and started to prove out the valueto patients, clinicians and payersof delivering more acute care in the home. Highmark, AHN and Contessa in 2020 announced a partnership to launch a home-based acute care model for Highmark health plan members.

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How to Make The Best Benefits Decisions for 2025's Workforce: An HR and Total Rewards Guide

Speaker: Kaitlin Ruby Carroll

Retaining top talent in 2025 means rethinking benefits. In a competitive job market, fertility benefits are more than just offerings - they are a commitment to your team’s well-being. Gain critical insights into the latest fertility benefits strategies that can help position your organization as an industry leader. Our expert will explore the unique advantages and challenges of each model, share success stories from top organizations, and offer practical strategies to make benefits decisions tha

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My Publications in 2024

Healthcare ECONOMIST

Here is the list of my papers that were published in 2024. Manuscripts were published in Value in Health , BMJ Open , Journal of Comparative Effectiveness Research , Forum for Health Economics and Policy, Annals of the American Thoracic Society and others. Links to all papers are below. Clayton D, Shafrin J , Yen GP, Geevarghese L, Shi Y, Waheed A. A Retrospective Claims Analysis of the Rate of Complications in Patients Undergoing Treatment for Paroxysmal Nocturnal Hemoglobinuria.

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Dealbook: Pennant Acquires Assets of Signature Healthcare at Home; Avid Health at Home Purchases Sandhills Home Care

Home Health Care

The Pennant Group (Nasdaq: PNTG) has completed its purchase of certain Oregon assets of Signature Healthcare at Home. The company previously acquired Signatures Idaho and Washington assets on August 1, 2024. We are delighted to welcome these operations to the Pennant fold, Brent Guerisoli, CEO of Pennant, said in a press release statement. This is a substantial purchase that allows us to serve multiple new markets across Oregon and cements Pennant as one of the leading providers of home health a

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CMS 1500 Claim Form Instructions: Simplified

Etactics

Around 50% of providers found that in 2023 instances of claim denials increased. Some of the top reasons for claim denials include errors in patient registration and other missing or incorrect documentation. Knowing the difference between the forms used in medical billing can be challenging as there are many different kinds! For example, weve previously discussed the benefits of knowing what a UB-04 form is.

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Here's Why Trump's Foreign Policy Is Hard to Pin Down

The Rand Blog

While some view President-elect Trump as an isolationist, this characterization overlooks his complex foreign policy. He may adopt restraint in certain areas, but he is likely to encounter strong pressure for deep engagement, especially regarding military involvement in Europe and the Middle East.

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Why Every Small Business Needs an HCM Solution: A Comprehensive Guide

Managing HR tasks like payroll, compliance, and employee data can overwhelm small businesses. That’s where a Human Capital Management (HCM) solution comes in. Our eBook, Why Every Small Business Needs an HCM Solution: A Comprehensive Guide , shows how an HCM system automates tedious processes, ensuring your business stays compliant and efficient. You’ll learn how to simplify payroll, eliminate costly errors, and empower your employees with self-service tools.