Wed.Dec 20, 2023

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UnitedHealth, OptumRx sued by independent pharmacy over ‘unconscionable’ fees

Health Care Dive

Osterhaus Pharmacy in Iowa — which is also suing CVS Caremark — is taking issue with pharmacy benefit managers’ use of performance-based fees that it says are contributing to independent pharmacy closures.

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2024 Outlook: 'Blurring of the lines' as providers, retailers and payers plotting primary care plays

Fierce Healthcare

Health systems, insurers, retailers like CVS and tech companies like Amazon are all scrambling for a bigger piece of the medical pie. | Patients are looking for easier access to medical services and more convenience and this is opening big opportunities for insurers, retailers, tech companies and nontraditional players to muscle their way into primary care.

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Steward Health Care hit with False Claims Act lawsuit

Health Care Dive

The suit alleges a Steward-run hospital improperly billed Medicare for more than 1,000 false claims.

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Obesity, primary care startup Knownwell raises $20M, launches program for teens

Fierce Healthcare

Knownwell, an integrated primary and obesity care provider, is launching a new teen program for weight management. | The new program aims to create a patient-focused environment to uncover and treat the root cause of early obesity. The care model is built on involving the teen’s family with nutritional counseling, behavioral health services and pharmacotherapy when appropriate.

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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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Shared Savings Program linked to net losses in traditional Medicare, study finds

Health Care Dive

However, the program was linked to savings in Medicare Advantage and for the CMS overall.

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VA deepens partnership with AppliedVR to expand access to immersive therapeutics

Fierce Healthcare

The Veterans Health Administration is tapping AppliedVR to expand military veterans' access to virtual reality-based therapy for chronic lower back pain. | The Veterans Health Administration is tapping AppliedVR to expand military veterans' access to virtual reality-based therapy for chronic lower back pain.

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Top drivers of food insecurity include disability, disease, FarmboxRx survey finds

Fierce Healthcare

The top contributors to food insecurity in American households are disability and disease, fixed income, age and being a single parent, according to | The FarmboxRx report surveyed more than 2,000 individuals living on food stamps to explore the factors driving higher food insecurity rates.

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How long does It take for vitamins to work?

Healthcare Associates

Starting a new vitamin regimen for your health can be exciting. Vitamins are naturally ingested through the foods we eat daily, but if you are lacking in one or some, your doctor may recommend you take supplements to replenish them in your body. You may have a few questions about it, such as how long it takes for the vitamins to work. When can you start to see the effects of particular vitamins?

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Rite Aid's 'reckless' use of AI facial recognition tech earns 5-year ban from FTC

Fierce Healthcare

Rite Aid has been hit with a five-year ban on the use of AI facial recognition technologies after the Federal Trade Commission (FTC) said the retail pharmacy chain “failed to implement reasonable p | The retail pharmacy chain's spotty facial recognition and "persons of interest" database generated "thousands" of false-positives, particularly among women and people of color, the FTC says.

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Not Just a Bill: The Importance of Empathy and Clarity in Healthcare Billing

HIT Consultant

Suman Chaudhuri, Vice President, CSG Forte When you leave the doctor, you’ll have a plan of care in hand. For instance, when you break an ankle, you may get instructions for the next 24 hours, a prescription, a follow-up appointment, a number to call if something goes wrong and a picture of what your next six weeks might look like. These plans are comprehensive and consider things like your activity level, the specific way your bone is broken, your ability to make it to appointments and any medi

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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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Editor's Corner—Fierce Health Payer's top 10 stories of 2023

Fierce Healthcare

Among our most-read stories of the year, one topic clearly rose to the top: Medicare Advantage. | Many of the most-read health insurance stories from Fierce Healthcare in 2023 center on Medicare Advantage.

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HIPAA Enforcement is Changing. Providers Must Too.

HIT Consultant

Cam Roberson, VP at Beachhead Solutions Healthcare delivery organizations and those working with them that are still in business are either well aware of their duties under HIPAA, work with managed service providers that understand the law well, or…are lucky to have made it this far. Even for organizations that have steered clear of both cyberattacks and regulatory fines, vigilance is essential to maintaining a clean bill of (cybersecurity) health.

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Fitch: Healthcare labor metrics are up, but there's still plenty of room for improvement

Fierce Healthcare

The healthcare labor pool continued its incremental crawl back to pre-pandemic trends during the waning months of 2023 with higher payrolls and flattening wage growth, per data from the U.S. | Hospital and ambulatory payrolls have improved for 22 and 34 consecutive months, while average hourly earning growth "has remained relatively flat" across the last few months, Fitch said.

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2024 Executive Forecast: What 6 Top Home Health Leaders Expect Next Year

Home Health Care

Staffing shortages, rate cuts and Medicare Advantage penetration will continue to be trends in the home health market in 2024. Those aren’t new. What is new, however, is how providers plan to combat the issues that stem from those trends. Home health leaders are focused on mitigating margin compression, utilizing more technology, leveraging Artificial Intelligence, working smarter with MA plans and more in the new year.

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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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The Carer QALY Trap

Healthcare ECONOMIST

The term “Carer QALY” was coined in a paper by Mott et al. (2023) and is identified as the case where “it is possible for an effective treatment that provides survival gains (with relatively little or no QOL gain) to appear less effective than the comparators when carer QOL is considered.” While the term “Carer QALY trap” is new, this issue has long been known.

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RPA Adoption: 74% of Hospitals Automate Revenue Cycle Tasks

HIT Consultant

What You Should Know: The healthcare revenue cycle is getting a major makeover, driven by a surge in automation and artificial intelligence (AI). A new survey by AKASA , a leading developer of AI-powered revenue cycle automation solutions, reveals that 74% of healthcare organizations are already automating some part of their revenue cycle operations, and 80% of those not currently using it plan to do so by the end of 2025.

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Psychological Safety in Healthcare with Tom Geraghty | E. 94

Vie Healthcare

Episode Introduction Tom outlines the evolution of psychological safety, why diversity will remain ‘’on paper’’ without inclusion, and why high-performing teams possess high degrees of psychological safety. He also explains the principle of the Andon Cord and how behaviors, practices and leadership are the three keys to creating psychologically safe working environments.

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Why We Cannot Wait Any Longer: The Urgent Case for AI in Healthcare

HIT Consultant

Charles Aunger, Managing Director, Technology | Health2047 In Handel Jones’ literary alarm, “When AI Rules the World,” we are drawn to envision an age where AI doesn’t merely complement but dominates every strand of our societal fabric. One domain in dire need of this revolutionary touch is healthcare — a sector where the United States, alarmingly, trails behind in the global AI adoption race.

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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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Intermountain Health Setting The Stage For ‘Long-Term Growth’ Of Hospital-At-Home Program

Home Health Care

Intermountain Health recently reached a major milestone with its hospital-at-home program. The health system has officially treated 1,000 patients at home since the launch of the program in 2020. Dr. Nathan Starr — the medical director of home services for Intermountain — considers the milestone especially significant with the context of the pandemic.

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VA Expands Access to Virtual Reality Pain Therapy for Veterans with AppliedVR Partnership

HIT Consultant

What You Should Know: – The U.S. Department of Veterans Affairs (VA) is taking a major step forward in pain management by expanding its contract with AppliedVR , a provider of immersive therapeutics (ITx) using virtual reality (VR). – This contract expansion will significantly increase access to RelieVRx®, the first and only FDA-authorized in-home VR treatment for chronic lower back pain (CLBP).

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The Top 10 Home Health Care News Stories Of 2023

Home Health Care

In the first year that truly felt “post-COVID,” home-based care providers did not see a shortage of challenges. Instead, in 2023, home health providers saw another year defined by payment struggles, with both the Centers for Medicare & Medicaid Services (CMS) and Medicare Advantage (MA) plans. Home care providers, meanwhile, were still grappling with high billing rates on the private-pay side.

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The SCOTUS Antibody Ruling Has an Uncertain Impact for Drug Makers and Patients

Bill Of Health

How Amgen v. Sanofi will affect innovation and the pharmaceutical industry. By Timothy Bonis Millions of patients rely on monoclonal antibodies. The global market in 2022 was $210B with a compound annual growth rate of 11 percent. Monoclonal antibody patents are now some of the world’s most valuable intellectual property. Monoclonal antibody patent law has been in turmoil for the past two decades.

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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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Yes, Alykhan. There is a Santa Claus

Healthy Debate

Family physician Alykhan Abudulla begins to doubt the existence of Santa Claus. He writes to the editor in search of answers.

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Absci, PrecisionLife Partner to Develop AI-Enabled Drug Pipeline

HIT Consultant

What You Should Know: – Absci , a generative AI drug creation company, and PrecisionLife , a pioneer in computational biology for complex chronic diseases, have announced a powerful partnership to develop a joint portfolio of potential therapeutics. – This collaboration aims to leverage the strengths of both companies to address unmet medical needs and accelerate drug development.

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How to succeed in value-based care without really trying

Nordic

In 1952, Shepherd Mead wrote How to Succeed in Business Without Really Trying , a tongue-in-cheek “instruction manual” based on his experiences climbing the corporate ladder. Sample chapter titles included “Stab the Right Backs,” “The Look of Suffering,” and don’t forget “Be a Meeting-Leaver.” The book was soon turned into a Broadway musical and then a movie!

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Healthcare AI News 12/20/23

HIStalk

News OpenAI posts a guide to GPT prompt engineering, explaining.

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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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Vietnam's Show of Welcome for Xi Reflects Growing Self-Confidence

The Rand Blog

Chinese leader Xi Jinping's recent visit to Vietnam aimed to reinvigorate bilateral ties, but produced mixed outcomes. Hanoi and Beijing signed a number of substantive bilateral deals, but Vietnam is also strengthening partnerships with other strategically significant nations, complicating any future Chinese aggression.

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Health Policy News December 2023

Health Policy News

Happy Holidays! As is customary for Health Policy News, our December 2023 edition is a retrospective of this past year, with a quick preview of topics and developments the Health.

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Inside Health Care #121: Peggy O’Kane and Driving Digital Transformation in 2024

NCQA

Peggy O’Kane We close 2023 with our annual year-end State of Health Care interview with NCQA President Peggy O’Kane. In this interview, Peggy talks with Vice President for Public Policy and External Relations, Frank Micciche, about NCQA’s progress in 2023—both in improving equitable access to health care and implementing digital transformation across the ecosystem.

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Reflections in 2023, Predictions for 2024

Health Policy News

Reflections in 2023, Predictions for 2024 Unwinding the Public Health Emergency Much of 2023 was spent planning for and implementing the end of the COVID-19 Public Health Emergency (PHE), while.

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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.