Fierce Healthcare

OCTOBER 24, 2024

Medicare Advantage (MA) insurers, namely industry titans UnitedHealth Group and Humana, could be using health risk assessments and chart reviews to inflate payments from Medicare through upcoding, | A federal watchdog is questioning whether UnitedHealthcare, Humana and other Medicare Advantage payers are either creating diagnoses out of thin air to inflate payments from Medicare or are not providing adequate care to sick members.

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Medicare 268

Health Care Dive

OCTOBER 24, 2024

The presidential election, loss of higher federal funding, inflationary pressures and other challenges are leaving state regulators uncertain about Medicaid’s “new normal.

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Medicaid Regulations 221

Fierce Healthcare

OCTOBER 24, 2024

Dyania Health is using artificial intelligence to automate manual patient chart review, boosting providers' ability to comb through medical records and speeding up medical research. | Dyania Health is using artificial intelligence to automate manual patient chart review, boosting providers' ability to comb through medical records and speeding up medical research.

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Healthcare It News

OCTOBER 24, 2024

Health systems that embrace artificial intelligence tools can not only improve radiology operations and quality but patient follow-up as well, which can result in greater staff efficiencies, higher patient completion rates and better access and outcomes for patients. A collaboration between East Alabama Medical Center, Inflo Health and the American College of Radiology Learning Network began using machine language models and advanced natural language processions to extract data from radiology re

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Primary Care Prevention Health Analytics Process improvement 212

Speaker: Simran Kaur, Founder & CEO at Tattva 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

Patient Experience

Health Care Dive

OCTOBER 24, 2024

The breach marks the largest ever reported to a portal managed by federal regulators.

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Regulations Healthcare 300

Health Care Dive

OCTOBER 24, 2024

Conservative planning and continued business growth helped Molina keep an ongoing mismatch between payment rates and member acuity from dinging its bottom line in the third quarter.

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Medicaid 144

Fierce Healthcare

OCTOBER 24, 2024

MultiPlan destroys market competition and engages in price-fixing with major insurers, a lawsuit from the American Medical Association (AMA) and the Illinois State Medical Society alleges.

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Health Care Dive

OCTOBER 24, 2024

Payers currently have a leg up when using AI to review claims, but providers could soon catch up, experts say.

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Fierce Healthcare

OCTOBER 24, 2024

California-based Molina Healthcare is seeing its stock rise dramatically after the company easily beat third quarter earnings expectations Oct. 24. | Molina Healthcare posted an adjusted earnings per share of $6.01 and $10.34 billion in total revenue.

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Healthcare 157

Speaker: Kaitlin Ruby Carroll

Fertility benefits have become a crucial component of employee well-being and retention strategies. In today’s competitive landscape, creating a fertility benefits program that aligns with both employee needs and organizational goals can be more complex than it seems. From cycle-based to flat-dollar and telehealth models, each solution offers unique advantages and challenges that directly affect employee satisfaction and financial well-being.

Health Care Dive

OCTOBER 24, 2024

The deal is Suki’s largest provider collaboration. Nearly 140,000 healthcare institutions use the Zoom platform.

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Healthcare 130

HIT Consultant

OCTOBER 24, 2024

What You Should Know: – Philips and Medtronic Neurovascular, an innovator in neurovascular therapies, have announced a strategic partnership to advocate for improved stroke care worldwide. – Recognizing the critical need for timely diagnosis and treatment of stroke, the two companies are joining forces to raise awareness, improve access to care, and leverage technology to enhance stroke outcomes.

Hospitals 94

Hospitals Healthcare 94

Home Health Care

OCTOBER 24, 2024

Direct care workers are, in many ways, the collective face of home-based care organizations. They are who clients and patients interact with. Therefore, regulators and providers are increasingly taking a closer look at who they’re hiring in the first place. While it is shocking to see caregivers commit crimes against clients, it does happen. About one in six people aged 60 and older experienced some form of abuse during 2023, according to the World Health Organization.

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Home Care Law Firms Medicaid Regulations 88

HIT Consultant

OCTOBER 24, 2024

What You Should Know: – PeopleOne Health , a pioneer in value-based primary care, has secured up to $32.3M in Series B funding led by GV (Google Ventures) , with participation from notable investors including healthcare entrepreneur Glen Tullman. – The funding will accelerate PeopleOne Health’s mission to transform primary care by providing a comprehensive, patient-centric, and cost-effective health benefit.

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Primary Care Prevention Doctors Healthcare 93

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The Rand Blog

OCTOBER 24, 2024

Having shown they can build ingenious technologies, SpaceX and other companies have become critical government partners. If those partnerships are to remain sustainable, both industry and government need to better understand what makes partners reliable. For any organization, that means prioritizing the health, skills, and needs of its workforce.

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HIT Consultant

OCTOBER 24, 2024

What You Should Know: – General Catalyst (GC) , a global venture capital firm, has announced a significant milestone with the raise of $8B in new capital consisting of $6B for GC’s latest fund – Fund XII – and $2B in separately managed accounts). – The substantial investment will accelerate GC’s mission to advance health assurance and drive transformative innovations across various sectors, including AI, healthcare, and global resilience. $750M Allocated to Health A

Accountability 96

Accountability Healthcare 96

Home Health Care

OCTOBER 24, 2024

LiveWell Partners recently acquired Hope Home Care, an Ohio-based home health provider. The deal is one of many finalized in recent weeks, reflecting a strengthened M&A environment in home-based care. The transaction will allow LiveWell Partners to expand its footprint in Ohio, which is a market key to the company’s growth strategy. “When you think about Ohio, it really is the outer edge of where we’re focusing strategically for our geographic scope,” LiveWell Partners CEO Jason Growe

Home Care 68

Home Care Physical Therapy Medicaid Medicare 68

HIT Consultant

OCTOBER 24, 2024

What You Should Know: – Abbott , a global healthcare leader, has announced a new clinical trial, TEAM-HF, designed to improve outcomes for patients with worsening heart failure. – The first-of-its-kind trial will leverage AI and Abbott’s CardioMEMS™ HF System to identify patients who may benefit from earlier intervention with advanced therapies, such as a HeartMate 3™ left ventricular assist device (LVAD).

Hospitals 89

Hospitals Healthcare Life Sciences 89

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.

Advanced Data Systems

OCTOBER 24, 2024

Integrating Artificial Intelligence (AI) into a podiatry practice can significantly enhance operational efficiency, improve patient outcomes, and streamline administrative tasks. However, the transition to AI-powered systems can seem daunting. Here are detailed, actionable steps to help you seamlessly integrate AI into your podiatry practice.

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Integration 61

HIT Consultant

OCTOBER 24, 2024

What You Should Know: – Authenticx, a top conversation intelligence platform for healthcare organizations, today announced the launch of Ava , an AI-powered in-app assistant that helps users quickly answer their most pressing business questions while serving up meaningful insights from their own data. – The AI assistant can analyze call transcripts, interpret correlations between AI models, provide coaching feedback on agent performance, and recommend strategic actions to take base

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Healthcare Prevention 67

Health Policy News

OCTOBER 24, 2024

Health Policy News October Hello readers! In this month’s edition of Health Policy News, our subject matter experts highlight opportunities in advancing oral health coverage. We also share information about.

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HIT Consultant

OCTOBER 24, 2024

Heather Cox, President of Insights & Empowerment, a division of Zelis When members are engaged in proactive care, it can improve clinical outcomes and reduce costs. Still, despite health plans’ many efforts to modernize and improve the member experience, motivating members to be active participants in their healthcare remains a challenge. Much of this challenge stems from a lack of clarity and transparency (what will something cost, which doctors or specialists are in the network, how to fin

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Doctors Healthcare Medicare 77

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.

Icanotes

OCTOBER 24, 2024

Social Determinants of Health and Substance Abuse: Understanding the Intersection Social determinants of health (SDOH) significantly influence substance abuse patterns and outcomes. For behavioral health clinicians treating substance abuse , understanding these social determinants—factors like economic stability, education, social support, and access to healthcare—is essential for effective assessment and treatment.

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Prevention Integration Clinical Practice Healthcare 52

HIT Consultant

OCTOBER 24, 2024

What You Should Know: – Dyania Health , an AI-powered healthcare data company, today announced the close of its $10 million Series A funding round led by HealthX Ventures with Tech Square Ventures and Cleveland Clinic Ventures, along with significant participation from existing investors. – Dyania’s Series A is driven by the growing demand for innovative solutions that address inefficiencies in healthcare data management and clinical research, positioning Dyania Health as a lead

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Life Sciences Quality of Care Healthcare 74

Health Policy News

OCTOBER 24, 2024

Conference Round Up PCG staff shares insights from additional conferences in another round up this month. This article includes key highlights from conferences we have attended on a range of.

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HIT Consultant

OCTOBER 24, 2024

What You Should Know: – Pangea Biomed , the startup behind the advanced cancer response prediction platform ENLIGHT, today announced the beginning of a pilot collaboration with the Knight Cancer Institute at Oregon Health and Science University (OHSU). – This collaboration will explore the ability to predict personalized cancer treatment response using data processed through the Serial Measurements of Molecular and Architectural Responses to Therapy (SMMART) Clinical Trials Progr

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Life Sciences 59

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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.

Healthcare

Health Policy News

OCTOBER 24, 2024

In 2024, CMS announced new policies intended to expand access to dental services though Marketplace plans, creating an opportunity for states to impact oral health directly and broader outcomes indirectly.

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HIT Consultant

OCTOBER 24, 2024

What You Should Know: – Cognosos , a provider of real-time location services (RTLS) for healthcare, has acquired Cox Prosight , an award-winning RTLS platform specifically designed for hospitals. – This strategic acquisition combines Cognosos’ AI-powered location technology with Cox Prosight’s robust platform, creating a cutting-edge solution to address the operational challenges faced by hospitals today.

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Hospitals Patient Experience Integration Healthcare 59

Health Policy News

OCTOBER 24, 2024

CMS Publishes EPSDT Strategies and Best Practices for States On September 26, 2024, the Centers for Medicare & Medicaid Services (CMS) published a State Health Official letter regarding best practices.

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Medicaid Medicare 52