Tue.Aug 27, 2024

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Feds killed plan to curb Medicare Advantage overbilling after industry opposition

Fierce Healthcare

A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars—only to abruptly back off amid an “uproar” fr | Filings and testimonies in a multibillion-dollar Justice Department civil fraud case against UnitedHealth Group outline industry pressure that led the government to bury a proposed rule on Medicare Advantage chart reviews.

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Semaglutide coverage for weight loss could cost Medicare billions: study

Health Care Dive

If all newly eligible patients received semaglutide, Medicare Part D spending could increase by $34 billion to $145 billion each year, according to new research.

Medicare 317
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TennCare violated healthcare rights of Tennessee Medicaid beneficiaries, judge rules

Fierce Healthcare

TennCare, the state of Tennessee’s Medicaid program, intentionally prevented families from receiving healthcare coverage and benefits, a federal district judge determined Aug. 26. | TennCare, the Tennessee state Medicaid program, was found to have intentionally prevented families from receiving healthcare coverage and benefits, a federal court found.

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Pfizer launches DTC service for migraine, COVID drugs

Health Care Dive

The platform is similar in concept to a service launched this year by Eli Lilly, and aims to give consumers easier access to Pfizer’s migraine, COVID-19 and flu treatments.

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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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Northwell, Nuvance merger wins state AGs' blessing

Fierce Healthcare

Northwell Health and Nuvance Health’s 28-hospital merger logged a key milestone Monday with word that Connecticut and New York’s attorneys general have conditionally signed off on the deal. | The attorneys general secured promises to maintain care services in western Connecticut and limit rate negotiations to single states. The $18 billion deal still awaits all-clears from state regulatory offices.

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New cancer patients check EHRs twice as often

Healthcare It News

Once a cancer diagnosis is confirmed, a patient's life is not only altered but there is a lot to learn as they make care decisions. "For cancer survivors and those managing a recent diagnosis, having access to online medical records via patient portals or smartphone-based health apps is critical," said researchers from the U.S. Health and Human Services in a new report that examines the use of electronic health information.

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Johns Hopkins, CareFirst, Techstars launch healthcare AI accelerator

Health Care Dive

The 13-week program will offer funding and guidance to up to 12 health tech, medtech and biotech startups working on AI tools.

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Oregon's hospital price cap policy cuts patients' out-of-pocket costs, bumps utilization

Fierce Healthcare

An Oregon policy capping maximum hospital payments appeared to reduce patients’ out-of-pocket spending, though their state health plan’s savings were fettered by a resulting increase in utilization | “These findings suggest that at least some savings from the price reductions were passed along to enrollees through lower out-of-pocket spending at the point of service,” researchers wrote in JAMA Health Forum.

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Better cancer outcomes from driving behavioral change

Healthcare It News

Enterprise Taxonomy: Quality Care Operations Health and Wellness Population and Public Health Patient safety Strategic Planning Digital Health Care Business Organizational Governance Technology Node settings: Exclude from Accelerate RSS feed

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Northwell-Nuvance deal gets green light from state attorneys general

Health Care Dive

To gain regulatory approval, Northwell agreed to invest in women’s health services and maintain staffing levels at Nuvance hospitals in the years following the merger, among other terms.

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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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KFF: A look at narrow networks in ACA marketplace plans

Fierce Healthcare

People enrolled in Affordable Care Act marketplace plans had access to 40% of the local physicians in-network, according to a new analysis from KFF.

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Physician Burnout: Over 25% of Physicians Do Not Utilize Their Annual Vacation Days

HIT Consultant

What You Should Know: – A recent report by G-Med , a global online physician community, sheds light on the alarming issue of physician burnout and its impact on vacation time. The report , based on extensive analysis of peer-to-peer discussions among verified physicians, reveals that a significant number of doctors are not taking all their allotted vacation days, either due to workload pressures or discomfort in requesting time off.

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FTC Targets Care.com For ‘Unlawful Practices,’ Orders $8.5M Refund For Users 

Home Health Care

The Federal Trade Commission (FTC) has taken action against Care.com, alleging that the company’s platform systematically deceived caregivers seeking jobs and failed to provide a simple way for families to cancel their paid memberships. Care.com is an online platform that connects people seeking to hire workers for various jobs – such as child and older adult care, care for individuals with special needs and pet sitting – with those looking for work.

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Pfizer Launches PfizerForAll: Connecting Patients to Care, Medications & Vaccinations

HIT Consultant

What You Should Know: – Pharmaceutical giant Pfizer launches PfizerForAll , a user-friendly platform designed to simplify access to healthcare and wellness management for Americans. – PfizerForAll addresses a common frustration: the difficulty of navigating the US healthcare system. – A recent poll by the American Academy of Physician Associates found that 65% of Americans find managing their health overwhelming, and 73% feel the system fails to meet their needs.

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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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Reimagining The Health Care System, With The Home At The Center

Home Health Care

This article is a part of your HHCN+ Membership Dr. Pippa Shulman, the chief medical officer at Medically Home, believes the home will eventually become the lynchpin of the U.S. health care system. “What you’re going to see is a full shift to the idea of hospitals, as a place where you seek ICU care, surgical care and emergency care for trauma, but that everything else can be delivered in the home,” she recently told Home Health Care News.

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The Importance of Between-Visits Appointments and Mental Health

HIT Consultant

Loren Larsen, CEO, Videra Health The causes and effects of America’s mental health crisis are well-documented. Easing access to necessary clinical help has not grown in tandem. A study by the National Council for Mental Well-Being reveals that mental health services in the U.S. are insufficient despite more than half of Americans (56 percent) seeking help, with limited options and long waits becoming the norm.

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Best Buy Health’s Latest Insights into Technology and Care at Home

Health Populi

In the U.S., aging in and staying at home is a priority for most people over the age of 45 — and for nearly one-half of younger people between 18 and 44 — we learn in Best Buy Health’s Research Brief discussing the company’s survey of 1,000 U.S. consumers. Best Buy Health, the health-focused operation which is part of the electronics retailer Best Buy, worked with Sage Growth Partners to assess 1,000 U.S. consumers, 18 years and over, on their perspectives on health care

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Ultrahuman Ring AIR Lands in Verizon Stores for Health Tracking

HIT Consultant

What You Should Know: – Ultrahuman , a leader in wearable health technology announced the availability of its innovative Ultrahuman Ring AIR in select Verizon stores nationwide. – By adding the Ultrahuman Ring AIR to its product lineup, Verizon continues to demonstrate its dedication to enhancing the lives of its customers through future-first wearable tech.

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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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Achieving cost savings and elevated care with the Expanse MaaS model

Meditech

From improved scalability and financial savings to enhanced service delivery and operational efficiency, the MEDITECH as a Service (MaaS) model is proving to be a game changer for organizations looking to stay ahead in a rapidly evolving landscape. Here are a few recent MaaS customers who are already poised to transform their care delivery.

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Elation Health Launches AI-Powered Note Generation Tool

HIT Consultant

What You Should Know: – Elation Health, the clinical-first technology company powering innovation in primary care, today announced the release of its ambient note generation product called Note Assist, an embedded artificial intelligence (AI) solution for its Electronic Health Record (EHR) platform, designed for the complex patient visit requirements of primary care. – With Elation’s Note Assist, the details of the physician-patient visit are ambiently transcribed and intelligent

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Navigating the new Epic Gold Star criteria with strategic approaches

Nordic

At Epic’s User Group Meeting 2024 , Epic announced new criteria for Gold Star, its 10-level continuous improvement program designed to help customers stay updated on the latest Epic functionality. While the program previously focused on organizations installing new features, it is expanding to include user adoption and measurable impact on clinical and financial performance.

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The Importance of Accurate Patient Matching for AI Projects

HIT Consultant

Avi Mukherjee, Chief Product and Technology Officer of Verato Andy Dé, Chief Marketing Officer of Verato. Famous artificial intelligence (AI) errors such as a Google search recommendation to put glue on a pizza to keep the cheese from falling off may cause a smile. However, when AI is mentioned in conjunction with healthcare, the stakes become serious — quickly since ‘hallucinations’ are not an option in healthcare!

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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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Special Touch Home Care CEO Looks Toward Expansion, Technology And The Next 150,000 Patients

Home Health Care

New York State has recently faced its share of challenges, including Gov. Hochul’s 2025 budget and the effort to reduce Medicaid spending, which directly impact the state’s Consumer Directed Personal Assistance Program (CDPAP). It seems the only constant in the state is change. Home Health Care News recently spoke with Special Touch Home Care CEO Evan Ostrovsky about the company’s 40-year history, serving 150,000 patients, its expansion into New York’s Consumer Directed Personal Assistance Progr

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Hinge Health, Midi Health Partner to Address Menopause-Related Musculoskeletal Issues

HIT Consultant

What You Should Know: – Hinge Health , a leading digital musculoskeletal care provider, and Midi Health , a virtual clinic specializing in menopause care, announced a strategic partnership to address the significant healthcare gap for women experiencing menopause-related musculoskeletal issues. – Menopause can significantly impact musculoskeletal health, leading to joint pain, muscle aches, and other discomfort.

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Momentum is Not Enough: A Call for Consistency in Psychedelic Legislation

Bill Of Health

by Karina Bashir The law helps establish legitimacy and inform societal norms—a role that becomes particularly pronounced in the field of psychedelics. Lingering stigma from the War on Drugs , despite the promising scientific potential of psychedelics, hinders the growth of the psychedelic industry and its public acceptance.

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Vouched Appoints Peter Horadan as New CEO

HIT Consultant

Peter Horadan, CEO at Vouched What You Should Know: – Vouched , the leading provider of AI-powered identity verification solutions for healthcare, banking, and financial services, has announced the appointment of Peter Horadan as its new Chief Executive Officer. – Vouched, founder John Baird will become the company’s Chairman of the Board and Chief Strategy Officer.

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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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News 8/28/24

HIStalk

Top News An ASTP/ONC study finds that 60% of people.

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Priority Health and Curai Offer Free Virtual Visits to Uninsured Michigan Residents

HIT Consultant

What You Should Know: – Priority Health , a nationally recognized nonprofit health plan serving more than 1.3 million members, and Curai Health, a leading virtual care provider, have announced a new partnership to offer free virtual visits to Michigan residents 18 and older who are without health coverage – an estimated 400,000 people. – The free virtual visits will be available through December 31, 2024.

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Don't Ever Invade China: Xi Jinping Prioritizes Border, Coastal, and Air Defense

The Rand Blog

China's national defense policy prioritizes safeguarding national territorial sovereignty and maritime rights with an emphasis on border, coastal, and air defense. Leader Xi Jinping underscored mainland defense in a recent speech. What does Beijing’s carefully crafted, high-profile political signaling tell us?

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ZBiotics Raises $12M to Expand First Genetically Engineered Probiotics

HIT Consultant

What You Should Know: – ZBiotics , the pioneers carving a new category of genetically engineered probiotics, today announced the close of its $12M Series A funding round, led by Spring Tide Capital. The oversubscribed round also includes participation by Access Capital, Seamless Capital, Goat Rodeo Capital, and Seaside Ventures. – The company will use the funds to meet growing consumer demand, spearhead retail expansion, and drive continued research and development in a new secto

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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.