Wed.Jul 10, 2024

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Federal Trade Commission to sue three largest PBMs: WSJ

Health Care Dive

Antitrust regulators are poised to file suit against CVS Caremark, Express Scripts and Optum Rx over how they negotiate discounts for drugs, including insulin, according to the report.

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WSJ: FTC to sue PBMs over drug pricing tactics

Fierce Healthcare

Just one day after issuing a report blasting pharmacy benefit managers for their business practices and focus on consolidation and vertical integration, the Federal Trade Commission (FTC) is report | The FTC is planning legal action against pharmacy benefit managers for rebate tactics that may hinder consumers and independent pharmacies.

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Addressing behavioral health resources and costs in Ohio

Healthcare It News

Like many in the U.S., Ohioans are experiencing a historic shortage of behavioral healthcare resources. But population health management tools from Alera Health will help the Ohio Behavioral Health Providers Network better integrate mental health care. Meanwhile, the state’s Miami University has awarded $1 million in funding to the Ohio Alliance for Population Health for the Southern Ohio Behavioral Health Corridor to support future behavioral health practitioners committed to the state

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How Chevron's demise could impact employers, purchasers, health payers

Fierce Healthcare

Healthcare legal observers are still reacting to the Supreme Court’s recent decision to gut the Chevron doctrine, fundamentally altering the power federal agencies have to handle regulations as the | Industry leaders and legal observers are still coming to terms with the Supreme Court's landmark decision to overturn the Chevron doctrine.

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How to Battle Layoffs: The Career Star Accelerator Bootcamp

Facing layoffs in your organization? Support your team members' career transition with Career Star Accelerator Bootcamp: Custom Resume & LinkedIn Revamp + 6 Weeks of Career Coaching. Our certified resume writers will create job search-winning resumes and LinkedIn profiles while they work with a career coach to learn unique strategies to stand out, attract the right employers, automate their job search, and land their dream job.

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Judge pauses CMS rule capping compensation for Medicare Advantage brokers

Health Care Dive

Texas Judge Reed O’Connor’s decision suggests he could overturn at least part of the rule, which is meant to curb predatory plan marketing to seniors.

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Cityblock expands footprint in North Carolina through Alliance Health partnership

Fierce Healthcare

Cityblock, a Medicaid value-based care provider, has partnered with Alliance Health, a managed care organization in North Carolina, to help members with serious mental illness and substance use dis | Cityblock now serves more than 41,000 members in North Carolina following its partnership with Alliance Health, a managed care organization.

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HHS releases HTI-2 proposed rule to advance interoperability for payer, public health IT

Fierce Healthcare

Just six months after finalizing a sweeping regulation with new requirements for AI transparency and interoperability, the federal government's healthcare tech arm is proposing another major policy | The rule establishes new certification criteria designed to enable health IT for public health as well as health IT for payers to be certified under the ONC Health IT Certification Program.

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Digital health funding shows improvement in 2024: Rock Health

Health Care Dive

U.S. digital health startups have raised $5.7 billion across 266 deals so far this year, putting the sector on track to possibly exceed recent full-year funding totals.

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The state of digital health investment in 2024

Fierce Healthcare

From 2020 to 2022, it was a wild ride for digital health with record-high deals and soaring valuations. | In this week’s episode of “Podnosis,” Executive Editor Heather Landi chats with Rock Health’s Megan Zweig to talk about the state of the digital health market, how startups and investors are taking a different approach to dealmaking and what to expect for the rest of the year.

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How automated RPM referrals help reduce readmissions

Healthcare It News

The HIMSS AI in Healthcare Forum is scheduled to take place September 5-6 in Boston. Learn more and register.

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5 Essentials for Healthcare CIOs: A Provider Data Management Checklist

Complete and accurate provider data is essential for health organizations to operate effectively. A better understanding of your provider network helps to understand patients and consumers, identify gaps in care, and make the best possible decisions for your businesses. A modern provider data management solution should power a complete and accurate view of each of your providers, make this data easily accessible across functional groups, and be flexible and agile enough to scale. with your needs

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CMS floats 2.6% annual outpatient, ASC pay increase, new obstetrics Conditions of Participation

Fierce Healthcare

A proposed rule outlining the Centers for Medicare & Medicaid Services’ (CMS’) intended Medicare payment rates and policy updates for outpatient and ambulatory surgical centers (ASCs) in the co | The administration's CY 2025 OPPS and ASC Payment Systems proposed rule looks to improve obstetrical services, quality reporting and care access.

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Stanford Medicine Launches AI-Powered Consult to Improve Clinical Decisions + Outcomes

HIT Consultant

What You Should Know: – Stanford Medicine is revolutionizing the way community physicians deliver care with the launch of Patients Like Mine, a suite of services designed to equip them with the data and resources needed to provide high-quality, evidence-based treatment to their patients. – By empowering community physicians with the tools and knowledge they need, this program has the potential to revolutionize healthcare delivery, ensuring high-quality, evidence-based care for all pa

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Sanford Health, Marshfield Clinic Health System unveil $10B merger plan

Fierce Healthcare

Midwest health systems Sanford Health and Marshfield Clinic Health System announced plans Wednesday to explore a merger forming a 56-hospital, $10 billion revenue nonprofit heavyweight. | Following a string of botched mergers for both parties, the nonprofits are getting back in the saddle for a 56-hospital, cross-market deal they say will deliver integrated care and new population health efforts across the Midwest.

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Empara Launches AI Virtual Assistant for Navigating Benefits

HIT Consultant

What You Should Know: – Empara , a developer of healthcare technology focused on making healthcare accessible, affordable and seamless, has announced the launch of Em, its customizable AI virtual assistant. – Em is designed to make the member experience of navigating benefits simpler, more intuitive and personalized, while also increasing the efficiency and effectiveness of service providers and HR teams.

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Level up Culture & EQ | Sign up for the #CultureDrop

Once a week, culture & leadership expert Galen Emanuele gives free, actionable EQ training in 5 minutes or less. Subscribe to the #CultureDrop and access free resources & content.

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Turning ‘Pain Points’ Into ‘Bliss Points’: The Chief Experience Officer’s Rise In Home-Based Care

Home Health Care

This article is a part of your HHCN+ Membership Despite variations in service lines, size and operations, the best home-based care organizations all have one thing in common. These companies all prioritize the experience — of patients, clients and staff. And while every member of an organization plays a role in shaping the experience, this responsibility largely rests on the shoulders of what is now known as the chief experience officer.

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HHS Proposes HTI-2 Rule to Enhance Healthcare Data Sharing and Interoperability

HIT Consultant

What You Should Know: – The U.S. Department of Health and Human Services (HHS) has taken a significant step towards improving healthcare information exchange with the release of the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule. – The HTI-2 rule marks a major advancement in interoperability by focusing on seamless data exchange between patients, providers, payers, and public health auth

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Climate Change Risk to National Critical Functions

The Rand Blog

The changing climate will strain the basic functions that underpin American society. Core services such as supplying water and electricity, providing medical care, and responding to emergencies like floods will face regional- or even national-level disruptions in the years to come.

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Oracle Strengthens Pharmacovigilance Solutions with AI-Powered Enhancements

HIT Consultant

What You Should Know: – Oracle announced significant updates to its Argus and Safety One Intake solutions , bolstering its pharmacovigilance portfolio with AI-powered features. – These AI enhancements cater to the evolving needs of life science organizations, allowing them to navigate increasingly complex regulatory landscapes and manage rising adverse event caseloads.

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A Guide to Improved Sepsis Detection & Compliance: 6 Areas You Should Address

This guide highlights key areas that your sepsis detection platform should address to minimize the impact of this leading, entirely preventable cause of in-hospital deaths, as well as how to increase compliance by 20% in 30 days. Download to learn more!

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Trinity Health At Home Tabs Dan Drake As Its Next CEO

Home Health Care

Trinity Health at Home – one of the largest home-based care providers in the country – has a new leader. Dan Drake has been named CEO of Trinity Health’s three national continuing care organizations: Trinity Health At Home, Trinity Health Senior Communities and Trinity Health Programs of All-Inclusive Care for the Elderly (PACE). Drake will officially take over on Aug. 1.

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Verantos Launches Alzheimer’s Disease Pragmatic Registry to Support RWE Generation

HIT Consultant

What You Should Know: – Verantos , the global leader in high-validity real-world evidence at scale, has launched its Alzheimer’s Disease Pragmatic Registry. – This registry offers life sciences organizations rich and reliable data on patients with Alzheimer’s disease and related conditions. Verantos: Leading High-Validity Real-World Evidence Verantos is the global leader in high-validity real-world evidence at scale.

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3 ways automation and AI advance patient-centered care

Nordic

Read more about how automation and AI drive patient-centered care with enhanced workflows, predictive analytics, and remote patient monitoring for improved outcomes and engagement.

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Samsung Unveils Galaxy Ring, Galaxy Watch7 & Galaxy Watch Ultra: Expands Wearable Lineup’s Health Intelligence Capabilities

HIT Consultant

What You Should Know: – Samsung Electronics today announced a significant expansion of their wearables portfolio with the introduction of Galaxy Ring , Galaxy Watch7 , and Galaxy Watch Ultra. – These new devices, powered by Galaxy AI, are designed to deliver a holistic and personalized wellness experience for users at all levels. Galaxy Ring: Unassuming Design, Powerful Insights The Galaxy Ring offers a discreet and comfortable approach to wellness monitoring.

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The New Tech Experience: Innovation, Optimization, and Collaboration

Speaker: Paul Weald, Contact Center Innovator

Learn how to streamline productivity and efficiency across your organization with machine learning and artificial intelligence! No matter what industry you're in - healthcare, customer service, sales, and more - it’s easier than you think to reduce wait times, monitor sentiment, and provide enhanced self-service options for all of your users. This means that you can achieve a more consistent and engaging customer experience while reducing sources of friction.

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Healthcare AI News 7/10/24

HIStalk

News OpenAI co-founder and CEO Sam Altman and Thrive Global.

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Alliance Health, Cityblock Partner to Deliver Integrated Care for Medicaid Members in North Carolina

HIT Consultant

What You Should Know: – Alliance Health , a managed care organization serving over 137,000 Medicaid beneficiaries in North Carolina, announced a new partnership with Cityblock , a value-based healthcare provider for Medicaid and dually eligible individuals. – The strategic collaboration aims to improve access to comprehensive, integrated medical and behavioral health care for members with serious mental illness and/or substance use disorder.

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Five Key Domains of Incident Management

The Rand Blog

Five key domains are core to incident management. Understanding them can help ensure incidents are managed appropriately using practices that can quickly and efficiently resolve them.

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CareFirst’s Healthworx Launches New Healthcare Accelerator for Startups

HIT Consultant

What You Should Know: – Healthworx , an agile group of healthcare experts, combines investment, strategic partnership, commercialization, and launch pad capabilities. They are introducing a reimagined accelerator for healthcare startups seeking funding and mentorship. – The Healthworx Accelerator, formerly known as 1501 Health, will equip startups with the necessary tools and knowledge to navigate and grow within complex and entrenched healthcare markets.

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Strategies to Deal with Collaborative Healthcare Communication

Speaker: Dr. Ugo Uwaoma, MD, MBA

Due to the impact of COVID-19, integrating telehealth software into practices and organizations has become the new normal. In turn, this has increased the effectiveness of collaborative healthcare by strengthening communication amongst healthcare workers and helping combat the woes of burnout. Communication between patients and healthcare providers has also improved, allowing patients to reach their providers easily and decreasing turnaround time.

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A Closer Look at The Center for Medicare & Medicaid Services’ Proposed Patient Safety Structural Measure

Beterra

Patient safety is a critical component of healthcare quality. Despite significant advancements, preventable harm remains a significant concern in healthcare settings. The Centers for Medicare & Medicaid Services (CMS) has proposed a new Patient Safety Structural Measure (PSSM) to improve patient safety in hospital settings. This new quality measure will assess how hospitals implement safety improvement systems and evaluate hospital leadership’s commitment to patient safety.

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Morning Headlines 7/11/24

HIStalk

Leading Healthcare Solutions Provider, Medicus IT, Announces Investment from FFL.

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HTI-2 proposed rule includes new certification criteria for payer and public health IT

Healthcare It News

The Office of the National Coordinator for Health Information Technology on Wednesday published its long-awaited Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability proposed rule for public comment. WHY IT MATTERS The HTI-2 proposed rule is designed to further advance interoperability and boost nationwide information sharing among patients, providers, payers, and public health authorities.

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CMS' proposed 2.8% physician pay decrease for FY2025 earns quick condemnation from docs

Fierce Healthcare

The Biden administration is proposing a 2.8% decrease to physician payments in its newly released pay proposal for physicians, drawing near-immediate protest from the industry. | A fifth consecutive year of pay reductions comes as practice costs continue to rise, spurring calls from groups like the AMA and MGMA for congressional intervention.

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Top 12 Telehealth KPIs Every Health Tech Leader Should Know

Speaker: Matt McBride, CEO and Co-Founder of Mend

Patient engagement happens before, during, and after interactions. Consumer research has found that in 2021, 64% of US households reported using Telehealth services. In addition 34% of patients would prefer Telehealth visits to in-office visits. Accessible patient engagement technology can help you improve your relationships with your patients while also improving your KPIs.