Wed.Nov 20, 2024

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PBMs strike back at FTC, claim administrative process is unconstitutional

Fierce Healthcare

The country’s largest pharmacy benefit managers and group purchasing organizations are going on offense against the Federal Trade Commission (FTC). | Major PBMs are countersuing the Federal Trade Commission, claiming the agency is biased and has too much authority to upend the industry.

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CareMax, dragged by Steward, files for bankruptcy

Health Care Dive

CareMax was the exclusive Medicare managed service organization to Stewardship Health. Steward’s bankruptcy posed an “existential threat” that CareMax said it couldn't overcome.

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Commonwealth Fund: Many enrolled in employer plans are underinsured

Fierce Healthcare

Close to a quarter of people who have health coverage are underinsured, meaning they're enrolled in plans that make it harder to afford care due to high out-of-pocket costs, according to a new stud | Close to a quarter of people who have health coverage are underinsured, meaning they're enrolled in plans that make it harder to afford care due to high out-of-pocket costs, according to a new study.

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UnitedHealth, Cigna, CVS sue FTC over insulin litigation process

Health Care Dive

The three companies are claiming the FTC’s suit is unconstitutional because it was lodged in the agency’s administrative court, instead of a federal one.

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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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Urban Institute: 4M could become uninsured if enhanced ACA subsidies end

Fierce Healthcare

Should policymakers choose not to extend enhanced subsidies for Affordable Care Act (ACA) plans, about 4 million people would likely become uninsured, according to a new analysis. | Should policymakers choose not to extend enhanced subsidies for Affordable Care Act plans, about 4 million people would likely become uninsured, according to a new analysis.

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Healthcare industry braces for RFK Jr.

Health Care Dive

Kennedy's views on vaccines in particular are causing alarm among some physicians and investors.

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Assisting the elderly in digital care

Healthcare It News

SMC Telogorejo Hospital has introduced a chatbot as part of its contact centre, which was found to be particularly helpful for its senior patients, notes president director Dr Alice Sutedjo Lisa.

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Commure rolls out AI scribe for Tenet Healthcare after yearlong customized build

Fierce Healthcare

Tenet Healthcare has selected Commure to provide an artificial intelligence scribe to providers throughout the health system. | With its forward deployed team of engineers, Commure started working alongside providers at Tenet Healthcare a year ago to deliver a custom AI scribe product. The company recently inked a deal with HCA Healthcare and acquired AI scribe company Augmedix earlier this year.

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Oak Street Health co-founder departs CVS

Health Care Dive

Mike Pykosz is leaving 18 months after he joined CVS with its acquisition of the value-based medical chain. He’s departing amid a flurry of high-level ousters at the struggling company — but isn’t one himself, CVS said.

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PCI DSS 4.0: A Guide to API Security for Healthcare Organizations

HIT Consultant

Stas Neyman, Director of Product Marketing at Akamai In recent years, several major health information exchange platforms in the United States have fallen victim to ransomware attacks. These platforms play a crucial role in U.S. healthcare infrastructure, facilitating the flow of patient records and managing payments for extensive networks of providers, including hundreds of thousands of doctors, tens of thousands of pharmacies, thousands of hospitals, and hundreds of laboratories.

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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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Providence names new COO

Health Care Dive

Darryl Elmouchi will take on the role effective Jan. 2 as Providence reshuffles its executive team.

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Why PE Firm Trive Capital Still Believes Home Health Is A Great Investment Area

Home Health Care

In recent years, Choice Health at Home has shaped up to be a company to watch in the home health space, and Trive Capital is one of its backers. Based in Dallas, Trive Capital is a private equity firm that has increasingly invested in the health care space. Brad Wiginton, managing director and head of business development at Trive Capital, recently connected with Home Health Care News at the FUTURE conference to dive deep on his company’s strategy.

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Suki AI Integrates with MEDENT and Azalea Health EHRs

HIT Consultant

What You Should Know: – Suki , the leader in artificial intelligence (AI) technology for healthcare, today announced two new partnerships with electronic health records (EHR) vendors, MEDENT and Azalea Health , who will each use Suki’s AI engine Suki Platform to directly embed AI capabilities within their respective solutions, enhancing user experience and improving patient care. – The two companies join existing strategic partners athenahealth and MEDITECH as members of Suk

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Is the gold card the golden ticket to fixing prior authorization?

Nordic

The health insurance landscape has seen prior authorization (PA) grow from a minor hurdle into a sprawling administrative maze. Once a way to ensure medical necessity, PA now contributes to delays, paperwork, and frustration that has affected both physician and patient experiences. Enter the “gold card” concept–a potential game-changer aimed at streamlining PA by exempting physicians with strong approval histories from routine reviews.

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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.

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Reimagine Care Enhances Post-Operative Cancer Care with Expanded Program

HIT Consultant

What You Should Know: – Reimagine Care , the nation’s leading on-demand cancer care provider, today announced an expansion of its innovative symptom-management program to now support surgical oncology patients, transforming the experience of post-operative cancer care. – Global demand for cancer surgery is predicted to increase by 52% by 2040, translating to an additional 5 million procedures.

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Healthcare AI News 11/20/24

HIStalk

News Microsoft enhances Microsoft 365 Copilot with task automation, new.

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Suicide is NOT a Symptom: Healthcare Is Missing the Mark on Suicide Prevention

HIT Consultant

Neil Leibowitz, MD, JD – Chief Medical Officer, Vita Health Too many have lost a loved one to suicide. Every 11 minutes someone dies by suicide in the US, often without warning. Suicidality has historically been regarded as a symptom of major depression and mental illness in general. During my training, when someone was at risk of suicide, we were taught to treat the underlying mental illness and the patient will get better.

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There is no placebo effect…but we still need them!

Healthcare ECONOMIST

That is the argument from an interesting post on the Carcinisation website titled “ A Case Against the Placebo Effect “ In short, the authors argue that placebos in-and-of-themselves may have small impact out health outcomes. However, care practices in clinical trials may be different such that health outcomes improve or people feel more cared for in the short-run.

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Best Practices to Streamline Compensation Management: A Foundation for Growth

Speaker: Joe Sharpe and James Carlson

Payroll optimization can be one of the most time-consuming and complex factors of small business management. Yet, organizations that crack the code on streamlining employee compensation often discover innovative avenues for growth. With the right strategies in place, outsourcing and streamlining payroll processes can result in substantial time and resource savings.

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World Class Health Secures $8M to Expand Global COE & Concierge Health Benefit

HIT Consultant

What You Should Know: – World Class Health , the largest Global Centers of Excellence (COE) and Concierge Health benefit that provides employees and their families access to the top 1 percent of hospitals and doctors worldwide, today announced an $8M seed round led by AlleyCorp with participation from LifeX , Joyance, Cooley & Co, City Light, Vivek Garipalli (Founder and Executive Chairperson of Clover Health), and Munjal Shah (Co-Founder & CEO of HippocraticAI.com). – The

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North Korean Desperation: Its Two Korea Theory

The Rand Blog

Kim Jong-un's regime is threatened by outside information and South Korean cultural influence. He has renounced peaceful unification, labeling South Korea an enemy. The United States and South Korea must bolster their alliance to counter North Korea's growing threats.

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Digital Medical Society Launches Resources to Navigate Global Digital Health Regulatory Pathways

HIT Consultant

What You Should Know: – Today, the Digital Medicine Society (DiMe) unveiled a suite of resources to guide industry in evaluating international regulatory pathways. These resources equip digital health technology developers with essential tools to compare and navigate the evolving, complex regulatory environments of an initial set of key markets across Asia Pacific, Europe, and North America. – With these tools in hand, developers will be able to streamline their global go-to-market

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Speculation on RFK Jr. as HHS Secretary

Healthcare ECONOMIST

From Tyler Cowen at Marginal Revolution : One of the problems with an RFK Jr. ascendancy is that his core views, which run strongly against vaccines and pharmaceuticals, make it unlikely that any of these reimbursement revisions will be done in a rational or scientific way. The best evidence indicates that pharmaceuticals are a relatively cost-effective ways of saving lives, and conversely that many costly surgical procedures are not very effective.

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How To Empower Your Workforce With Modern Fertility Benefits

Speaker: Andrea Wuchiski

In an era where a workforce spans multiple generations, HR managers and Total Rewards leaders face the unique challenge of designing benefits packages that cater to diverse employee needs. This session will delve into how comprehensive fertility benefits can bridge generational gaps, support employees’ health, and enhance workplace satisfaction. Join us for an insightful session that highlights the strategic importance of fertility benefits in today’s competitive job market.

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Predictive Dialer vs. Auto Dialer

Sequence Health

In today’s healthcare industry, ensuring efficient and timely communication with patients is essential. Call centers are central to managing patient inquiries, scheduling, and follow-up communications. A predictive dialer vs. auto dialer system can significantly impact how effectively a healthcare call center operates. By understanding their differences and benefits, healthcare providers can select the right solution to enhance patient engagement , improve agent productivity, and streamline the

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NY Department of Health Bolsters Hospital Cybersecurity Regulations

HKLaw

The New York State Department of Health (NYSDOH) adopted new hospital cybersecurity requirements to enhance the protection of patients' protected health information (PHI), as defined in HIPAA, and personally identifiable information (PII).

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Keys to QI training success

Life Qi

This article delves into the keys to QI training success, guiding you through the importance of such programs and designing effective training structures.

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Massachusetts to Begin Licensing Nonresident Pharmacies and In-State Compounding Pharmacies

HKLaw

Massachusetts Board of Pharmacy to Begin Licensing Nonresident Pharmacies and In-State Compounding Pharmacies and Expects to Issue Licensure Requirements in December 2024

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Enhance Healthcare Efficiency With Top Payroll & HCM Services

Running a healthcare facility requires precision and care, not just for patients but also for your staff. Our guide, "A Buyer’s Guide to Payroll & HCM Services," helps healthcare providers choose the best provider. Efficient payroll management ensures timely, accurate payments, critical for maintaining staff morale and trust. Compliance support helps navigate complex healthcare regulations and avoid costly fines.

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The UK's Digital Veteran Card: An Opportunity to Improve Service Access

The Rand Blog

The United Kingdom will launch a digital Veteran Card in 2025 to improve access to services for former military personnel. This initiative aims to streamline veteran status verification, enhance service accessibility, and support employment and justice system integration.

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Morning Headlines 11/21/24

HIStalk

Verisma Acquires Olah, Streamlining Patient Data Management for Hospitals and.

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Former Home Health Owner Sentenced To Prison For Role In Near-$8 Million Fraud Scheme

Home Health Care

The former owner of a home health company was sentenced to three years and five months in prison last week for his role in a nearly $8 million fraud scheme. Specifically, Muhammad Zafar – of Wayne County, Michigan – offered kickbacks, bribes and other “inducements” to beneficiary recruiters in exchange for Medicare beneficiary information, according to the Department of Justice (DOJ).

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Vorro CEO Talks Bridging the Interoperability Gap in Healthcare

HIT Consultant

Scott Sirdevan, CEO of Vorro Despite government mandates and advancements in technology, EHR interoperability remains a significant challenge for clinicians. A recent KLAS report highlighted widespread dissatisfaction with external data integration, hindering efficient care delivery and contributing to clinician burnout. In this exclusive interview, Scott Sirdevan , CEO of Vorro , a leading provider of no-code data integration solutions, provides expert insights into the complexities of interope

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Creating a Company Culture of Care: Integrating Mental Health, Wellbeing, and DEI in Benefits

Speaker: Sean Raible

Picture a workplace where physiological safety is not just an aim but a reality, driven by thoughtful employee benefits that prioritize mental health, wellbeing, and DEI. 🤔 ✨ Achieving this vision requires more than just occasional training sessions and employee assistance programs. Moving beyond the basics, this vision calls for a holistic approach that integrates these elements into your company culture as well as your HR and benefits strategy.