Thu.Oct 03, 2024

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CMS faces another star ratings lawsuit, this time from UnitedHealthcare

Fierce Healthcare

Another significant legal headache related to star ratings is on the table of the federal government just days before open enrollment begins. | One call center interaction is at the crux of a lawsuit UnitedHealthcare is bringing forward against the federal government because of a reduced star rating score.

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Humana’s Medicare Advantage dilemma worsens amid precipitous drop in 2025 star ratings

Health Care Dive

Only 25% of Humana members will be in plans with four stars or above next year, down from 94% this year, the insurer disclosed Wednesday. The downgrade could wipe out Humana’s profits in 2026.

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Texas sues PBMs, manufacturers over insulin ‘conspiracy’

Fierce Healthcare

The state of Texas is accusing major pharmacy benefit managers and drug companies of colluding to raise the cost of insulin. | Texas is suing drug manufacturers and the big three PBMs for insulin pricing tactics that adversely impacted the state's diabetes patients.

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Teladoc COO to depart at year end

Health Care Dive

Mike Waters’ resignation comes after other leadership changes at the telehealth vendor, including the departure of Teladoc’s former CEO this spring.

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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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Leading cancer centers launch Cancer AI Alliance with $40M from big tech

Fierce Healthcare

Four of the nation’s leading cancer centers are coming together to work on AI through a newly formed collaborative, the Cancer AI Alliance (CAIA). | Four leading cancer centers are leveraging their data resources and AI to gain ground on cancer.

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More Trending

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CMS authorizing accelerated, advance payments for hurricane-impacted providers, suppliers

Fierce Healthcare

Providers and suppliers feeling the weight of Hurricane Helene and its aftermath will see accelerated and advance Medicare payments, alongside other assistances and flexibilities, the Centers for M | CMS said it wants to head off “significant cash flow issues from the unusual circumstances impacting facilities’ operations.” It is also offering other flexibilities around debt repayments.

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Medicare tweaks rules for second round of drug price talks

Health Care Dive

The agency will offer earlier meetings with drugmakers as well as solicit more patient feedback on the process.

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WebMD Ignite launches engagement tool for health plan care managers

Fierce Healthcare

WebMD Ignite is broadening its reach in the health insurance space with the launch of a new tool that aims to bolster care management programs. | WebMD Ignite is broadening its reach in the health insurance space with the launch of a new tool that aims to bolster care management programs.

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Health Care Giants Are Falling Short Of Home-Based Care Disruption

Home Health Care

This article is a part of your HHCN+ Membership The biggest retailers were zealous in their pursuit of home-based health care initiatives. But there’s little evidence to suggest that pursuit has been successful, at least thus far. This week, CVS Health (NYSE: CVS) announced that it was laying off 2,900 workers. Simultaneously, reports surfaced of Glenview Capital – a significant shareholder in the company – emerging as an activist investor.

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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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WebMD Ignite Launches Coach for Health Plans to Boost Member Engagement

HIT Consultant

What You Should Know: – WebMD Ignite, a leading full-service growth partner for organizations in the healthcare industry, today announced the launch of Coach®, an integrated solution that enhances and elevates care management programs. – Engineered specifically for health plans, Coach is a comprehensive platform that integrates seamlessly into care managers’ workflows, enabling them to deliver tailored health education, videos and interactive resources to members to improve

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EPtalk by Dr. Jayne 10/3/24

HIStalk

The American Medical Informatics Association has given a shout-out.

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Pager Health Reimagines Personalized Healthcare with Generative AI

HIT Consultant

What You Should Know: – Pager Health , a connected health platform company serving more than 26 million members in the United States and Latin America, today announced the launch of ReallyWellSM. – Combining clinical support, wellness services and contextual navigation, ReallyWell leverages generative AI to conduct deep-dive analyses of all-encompassing data sets for each member and patient, creating an unprecedented, one-size-fits-one personalized engagement experience for health

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6 Takeaways from MEDITECH LIVE 2024

Meditech

With our largest in-person turnout since 2020, this year’s MEDITECH LIVE crowd was buzzing with discussions on AI, interoperability, the power of data, and other opportunities for innovation in the health IT space.

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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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Rezilient Health Secures $10M to Expand CloudClinics™ in MO, TX, OK

HIT Consultant

What You Should Know: – Rezilient Health, a St. Louis-based tech-enabled healthcare company, announced today that it has secured $10M in Series A funding led by Govo Venture Partners , with participation from Bridge Ventures, Acorn Pacific Ventures , The Council , and notable angel investors including Jim McKelvey (Co-Founder of Block), Mark and Robyn Jones (Founders of Goosehead Insurance), Jeremy Friese (Founder of Verata Health), and David Karandish (Founder of Answers.com). – The

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How Vesta Healthcare Raised Over $60M To ‘Integrate’ Personal Home Care

Home Health Care

On some days, Vesta Healthcare CEO Randy Klein’s job requires some preaching. Having a unique business model is a strength, but it also means dedicating time to explain how the company operates and its overall value add. It’s a position Klein has often found himself in. “I used to have a boss that referred to that as an ‘evangelical sale,’ because you actually have to evangelize what you’re doing,” he told Home Health Care News on the latest episode of the Disrupt podcast.

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HHAeXchange Acquires Sandata Technologies: Expanding Homecare Solutions

HIT Consultant

What You Should Know: – HHAeXchange , a provider of homecare management solutions, announced today its acquisition of Sandata Technologies , a veteran in the homecare industry with four decades of experience. Financial details of the acquisition were not disclosed. – The strategic move strengthens HHAeXchange’s position in the rapidly growing home and community-based services (HCBS) market, where demand for personal care aides is projected to increase by 43% between 2020 and 20

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VNS Health Research Leads To New Diagnostic Code, Aiding Post-Acute Care Providers 

Home Health Care

The Centers for Disease Control and Prevention (CDC) added a new diagnostic code to their annual update of the International Classification of Diseases (ICD-10) list. The new code, z512A, supports providers in hospitals and health facilities by alerting home care clinicians and other post-acute care providers when a patient is being discharged to aftercare following hospitalization for sepsis.

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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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Updates to Breast Cancer Screening Age Range for HEDIS MY 2025

NCQA

NCQA is changing the age range for the HEDIS Breast Cancer Screening measure to align with new U.S. Preventive Services Task Force (USPSTF) guidelines. Changes will be reflected in the HEDIS MY 2025 Volume 2 Technical Update. What’s Changing? The measure will include these changes for MY 2025: Expanded the age range to 40–74. Added age stratifications for 40–49 and 50–74 years of age, along with a total rate.

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News 10/4/24

HIStalk

Top News Virtual care chronic disease management vendor Omada Health.

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A Concerning Rise in Rough Sleeping Threatens Recent Progress on Unsheltered Homelessness in Los Angeles

The Rand Blog

In Los Angeles, rough sleeping—living without the protection of a vehicle, tent, or makeshift dwelling—has risen to new heights. If left unaddressed, this increase in the most precarious form of homelessness sets back recent progress in Los Angeles's efforts to combat this crisis.

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Morning Headlines 10/4/24

HIStalk

Diabetes startup Omada Health has confidentially filed its S-1 to.

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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.

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GAO wants CMS to check whether hospitals' price transparency data are actually usable

Fierce Healthcare

The Biden administration could stand to take a firmer hand on hospital price transparency, especially when it is unclear whether the price data being published are even accurate, the Government Acc | A new watchdog report showed no CMS assessments of whether hospitals' machine-readable files are complete or accurate.

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Lawmakers urge Biden administration to extend telehealth prescribing flexibilities for opioid use disorder

Health Care Dive

A bipartisan group of two dozen representatives pushed officials to preserve the pandemic-era prescribing changes for buprenorphine, arguing telehealth increases access and prevents overdoses.

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Comprehensive dental coverage gaining traction in Congress

Fierce Healthcare

Last month, Rep. | House Rep. Debbie Dingell introduced a bill that would expand dental coverage to tens of millions of Americans. The goal is gaining popularity among voters and elected Democrats.

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VieCure Secures 45M for AI-Enabled Community Oncology Care Platform

HIT Consultant

What You Should Know: – VieCure Inc., pioneer of next-generation intelligence platforms that democratize community oncology care, today announced the completion of a $45 million financing led by Northpond Ventures and the appointment of industry veteran Richard Daly as chairman of the board of directors. – The company will use the proceeds to scale commercial operations to meet the growing demand for its patented Halo Intelligence platform.

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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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The Evolution of Prenatal Monitoring: How AI and Remote Monitoring Can Improve the Provision of Care

HIT Consultant

Amit Reches, CTO, Nuvo Group Prenatal monitoring technology has advanced considerably over the last decade. High-resolution sonograms now offer unprecedented clarity, enabling detailed insights into fetal development. Meanwhile, innovations have transformed previously cumbersome and uncomfortable equipment into more portable and user-friendly devices, enhancing accessibility and patient comfort.