Health Care Quality Digest

Federal agencies open online portal for reporting anticompetitive practices in healthcare

Fierce Healthcare

APRIL 18, 2024

Federal agencies want to hear from the public about monopolistic and anticompetitive behavior within the healthcare industry. | FTC, DOJ and HHS said that information and accounts received from the public could plant the seeds for formal investigations into healthcare companies' monopolistic or anticompetitive practices.

Healthcare

Healthcare Accountability

AI medical assistants see rapid growth as health systems turn to tech as a cure for the burnout crisis

Fierce Healthcare

APRIL 17, 2024

Health systems across the country face the same pressing problem — rising levels of burnout among physicians. It’s a challenge that’s reaching a crisis point. | A growing number of hospitals and health systems are betting on advancements in AI as part of the cure for what ails physicians. Rush University System for Health is partnering with Suki to trial its AI assistant and Children’s Hospital Los Angeles is rolling out Nabla's Copilot tool.

Hospitals

Patient advocates shred Becerra’s copay accumulator comments during House hearing

Fierce Healthcare

APRIL 18, 2024

Lawmakers pressed Department of Health and Human Services Secretary Xavier Becerra over the Biden administration’s stance toward Medicare Advantage, rural health and more during budgetary hearings | HHS Secretary Xavier Becerra's comments on copay accumulators left patient advocacy groups baffled during a House hearing on the fiscal year 2025 budget.

Medicare

30 health systems pursuing top-to-bottom age-friendly care with new collaborative

Fierce Healthcare

APRIL 18, 2024

Thirty health systems from across the country have signed onto an 18-month initiative to explore how best to provide quality care for older adults. | The Age-Friendly System-Wide Spread Collaborative will see CommonSpirit Health, Advocate Health and others sharing data and best practices on how to provide quality care for older adults at every location.

Elevance Health sees double-digit profit growth in Q1, posting $2.2B in earnings

Fierce Healthcare

APRIL 18, 2024

Elevance Health's first-quarter profit grew by double digits year over year, reaching $2.2 billion, according to its earnings report released Thursday morning. | Elevance Health's first-quarter profit grew by double digits year over year, reaching $2.2 billion, according to its earnings report released Thursday morning.

Most doctors, consumers need transparency to trust generative AI in clinical decisions, survey finds

Fierce Healthcare

APRIL 17, 2024

Though physicians are quickly growing more comfortable with generative AI, the vast majority expect models to be transparent and trained on credible information, a new

Doctors

Providers pitch their post-Change cybersecurity policy fixes to sympathetic Congress

Fierce Healthcare

APRIL 16, 2024

Healthcare providers held the receptive ears of lawmakers during a congressional hearing Tuesday morning exploring cybersecurity and related policy changes to be made in the wake of the Change Heal | With UnitedHealth Group out of the room, lawmakers were happy to entertain providers' calls for greater third-party cybersecurity liability and antitrust during a recent subcommittee hearing.

Healthcare Providers

Healthcare Providers Healthcare

House to discuss national data privacy bill with implications for healthcare

Fierce Healthcare

APRIL 16, 2024

The House Energy & Commerce subcommittee on innovation will hold a hearing Wednesday to discuss data privacy and the protection of kids online. | The House Energy & Commerce Committee holds a legislative hearing to discuss a slate of privacy and online safety bills Wednesday, one of which would give consumers more control over health data collected by apps and big tech.

Healthcare

Healthcare Health Data

Health equity has become an organizational priority as data capabilities slowly mature, EY finds

Fierce Healthcare

MARCH 28, 2024

Three-quarters of polled health equity executives expect their area of expertise to become a greater priority over the coming year, a new EY report has found. | Though organizations are increasingly shifting from collecting data to using it to inform efforts, bigger entities with more resources tend to be more mature in these capabilities.

As Change reviews data impacted by cyberattack, here's what the notification process could look like

Fierce Healthcare

MARCH 28, 2024

Change Healthcare issued an update late Wednesday confirming that an analysis of the data accessed in the cyberattack on its systems is underway, and experts say the process of notifying people who | Change Healthcare issued an update late Wednesday confirming that an analysis of the data accessed in the cyberattack on its systems is underway.

Healthcare

CMS limits scope, improves transparency of 'junk' plans in final rule

Fierce Healthcare

MARCH 28, 2024

The Biden administration is releasing new standards around "junk" insurance, the Department of Health and Human Services and Treasury Department announced Thursday. | The Biden administration is continuing to crack down on "junk" health insurance plans. A final rule was released Thursday detailing the changes.

Hospital finances continue recovery in February, but Change Healthcare's full impact still on the horizon

Fierce Healthcare

MARCH 28, 2024

Hospital operations broadly maintained their strong momentum through February thanks to high revenues and quicker discharges, though the month’s metrics aren’t yet showing the full impact of Change | Monthly hospital sector data show higher revenues, shorter length of stay and lower per-discharge expenses in February. But, challenges are on the horizon due to the industry-wide disruption brought by Change Healthcare's outage.

Hospitals

Hospitals Healthcare

Behavioral health company Forge Health looks to double down on payer, provider partnerships to serve complex medical patients

Fierce Healthcare

MARCH 28, 2024

Behavioral health company Forge Health looks to double down on payer, provider partnerships to serve complex medical patients hlandi Thu, 03/28/2024 - 09:01

Walgreens takes $6B hit in Q2 from VillageMD investment

Fierce Healthcare

MARCH 28, 2024

This is a developing story and will be updated following Walgreens' Q2 earnings call this morning. | Walgreens lost nearly $6 billion in its fiscal 2024 second quarter to write down the value of its investment in primary care clinic chain VillageMD.

Primary Care

Revenue cycle management vendor R1 RCM receives $5.8B buyout offer from shareholder New Mountain Capital

Fierce Healthcare

FEBRUARY 26, 2024

Revenue cycle management technology giant R1 RCM has received an offer from private equity firm New Mountain Capital to buy out the roughly two-thirds of shares it doesn’t already own and take the | The private equity firm and its affiliates currently control almost a third of R1 RCM's shares. The all-cash offer's disclosure on Monday drove stock prices up by about 32% compared to Friday’s close.

b.well Connected Health raises $40M to scale platform unifying patient data

Fierce Healthcare

FEBRUARY 26, 2024

b.well Connected Health, maker of a platform unifying patient data, has announced a $40 million series C funding round. | b.well brings together a patient’s data by connecting a variety of stakeholders, including doctors, pharmacies, labs and devices, in one platform. It also provides personalized content that guides patients to take specific actions, harnessing behavioral psychology and game theory to engage the consumer in their health journey.

Doctors

CarelonRx to launch weight management program with digital coaching

Fierce Healthcare

FEBRUARY 26, 2024

Elevance Health's CarelonRx will begin offering a weight management program, providing its members access to digital-first coaching and wellness tools. | Elevance Health's CarelonRx will begin offering a weight management program for members, including those that take GLP-1 medications.

Steward Health Care shares recovery strategy but falls short of Massachusetts governor's documentation demands

Fierce Healthcare

FEBRUARY 26, 2024

Under fire from government officials, Steward Health Care released a six-point action plan late Friday outlining a $150 million financing agreement, asset sales and a partial restructuring that wil | The strained for-profit system shared word that it has secured a $150 million financing agreement with its lenders and is working to sell several assets to "reset its operations and address vendor obligations.

Many disproportionate share hospitals face lower Medicaid payments under new final rule

Fierce Healthcare

FEBRUARY 21, 2024

Medicaid disproportionate share hospital (DSH) payments are being cut by $8 billion annually during the current and next four federal fiscal years under a new Centers for Medicare and Medicaid Serv | Published Tuesday and set to go into effect in two months, the final rule limits the calculation of a hospitals Medicaid shortfall to beneficiaries with Medicaid as their primary payer.

Medicaid

Medicaid Hospitals Medicare

Massachusetts 1115 waiver success can translate to New York: experts

Fierce Healthcare

FEBRUARY 21, 2024

The blueprint set forth by Massachusetts accountable care organizations to improve population health metrics and reduce costs can be applied to New York, after Centers for Medicare & Medic | New York's section 1115 waiver allocates $500 million toward social care networks to connect community health workers with local organizations. ACO leaders and tech experts say the state can learn from Massachusetts' experience.

Accountable Care

Accountable Care Population Health Accountability Medicare

UCHealth filed over 15,000 lawsuits against patients over 5 years, often under another name, report finds

Fierce Healthcare

FEBRUARY 21, 2024

Over the past half decade, 15,710 collections lawsuits have been filed against patients by or on behalf of Aurora, Colorado-based UCHealth, according to a recently published investigative report.

'Podnosis': What are the healthcare sector’s sustainability needs?

Fierce Healthcare

FEBRUARY 20, 2024

In the U.S., where the healthcare sector emits significantly more carbon emissions than the aviation industry, hospitals are starting to think about ways to address their climate footprint.

Healthcare

Healthcare Hospitals

Study: Chronic worker shortages in nursing homes must be addressed to help lessen patient risk

Fierce Healthcare

FEBRUARY 16, 2024

The now chronic problem of more expensive agency staff and potentially lower quality care in nursing homes needs to be addressed as part of calls for increased oversight of the sector, according to | The now chronic problem of more expensive agency staff and potentially lower quality care in nursing homes needs to be addressed as part of calls for increased oversight of the sector, according to a recent academic study in Health Affairs.

Nursing

AT&T's 125,000 employees now have fertility, family building benefits through Maven Clinic

Fierce Healthcare

FEBRUARY 16, 2024

AT&T employees now have access to fertility and family building support from Maven Clinic. | All of AT&T’s 125,000 employees, across corporate, retail, technicians and union, now have access to Maven’s fertility and family building program. AT&T has offered Maven’s maternity program since 2021.

Health systems struggle to put AI governance policies in place to keep up with tech innovation

Fierce Healthcare

FEBRUARY 16, 2024

As the use of artificial intelligence in healthcare rapidly grows, hospital executives are still wrangling with practical questions around governance policies to establish basic rules of the road.< | As the use of artificial intelligence-based solutions in healthcare rapidly grows, health system executives are still wrangling with practical questions around governance policies to establish basic rules of the road.

Hospitals

Hospitals Healthcare

'New set of digital table stakes': Most executives see tech as worthy investment, EY survey finds

Fierce Healthcare

FEBRUARY 16, 2024

Nearly all healthcare executives believe new digital health technologies are worth the cost, even though they have yet to see a financial return from it, a new survey reveals. | Nearly all healthcare executives believe technology is worth the cost, even though they have yet to see a financial return from it, according to a new survey from EY. Most believe in its power to reduce costs and boost provider credibility.

Health Technology

Health Technology Healthcare

Chutes & Ladders—Spring Health hires new COO

Fierce Healthcare

FEBRUARY 16, 2024

Welcome to this week's Chutes & Ladders, our roundup of hirings, firings and retirings throughout the industry.

Surprise billing disputes continue to far outpace federal estimates: CMS

Fierce Healthcare

FEBRUARY 16, 2024

The number of balance billing disputes reaching arbitration is far higher than federal projections suggested, according to new data from the Biden administration. | The number of balance billing disputes reaching arbitration is far higher than federal projections suggested, according to new data from the Biden administration.

Medication abortions over telehealth effective and safe, researchers share ahead of major SCOTUS case

Fierce Healthcare

FEBRUARY 16, 2024

The effectiveness and safety of medication abortions obtained via telehealth are on par with those delivered in person, with no differences in outcomes between synchronous and asynchronous communic | Both synchronous and asynchronous approaches to medication abortion led to outcomes on par with in-person prescribing, a finding that addresses one of the key issues SCOTUS is scheduled to consider next month.

Fierce Healthcare Fundraising Tracker—Ezra picks up $21M backed by Former One Medical CEO's VC

Fierce Healthcare

FEBRUARY 11, 2024

A new year brings a new approach to tracking health tech and digital health investments. | Each week, Fierce Healthcare will publish a roundup of health tech and digital health financing rounds.

Healthcare

Papa’s New Impact Programs Add Value for Health Plans

Fierce Healthcare

FEBRUARY 7, 2024

Papa’s New Impact Programs Add Value for Health Plans jpiatt Wed, 02/07/2024 - 12:00

Chutes & Ladders—Prominent Republican won't seek reelection

Fierce Healthcare

FEBRUARY 9, 2024

Welcome to this week's Chutes & Ladders, our roundup of hirings, firings and retirings throughout the industry.

Virgin Pulse, HealthComp unveil rebrand as employer health company eyes accelerated growth

Fierce Healthcare

FEBRUARY 7, 2024

Three months following the merger of Virgin Pulse and benefits administrator HealthComp, the combined company has rebranded as Personify Health with its sights set on revamping the patient experien | Personify Health introduced what it calls a personalized health platform that combines HealthComp's health plan administration capabilities with Virgin Pulse's holistic wellbeing solutions and comprehensive health navigation.

Healthcare

'Podnosis': Catching up with the Fierce 15 of 2019 (part 2)

Fierce Healthcare

FEBRUARY 5, 2024

This is the second part of our series reconnecting with Fierce 15 winners from 2019, the first year Fierce Healthcare published the list of 15 private companies engaged in pioneering work

Healthcare

Amazon cuts hundreds of jobs in One Medical, Pharmacy units

Fierce Healthcare

FEBRUARY 7, 2024

Amazon is eliminating a "few hundred roles" across One Medical and Amazon Pharmacy, the company confirmed Tuesday. | Amazon is eliminating a "few hundred roles" across One Medical and Amazon Pharmacy, the company confirmed Tuesday.

Cigna Group posts $1B in profit in Q4 earnings beat

Fierce Healthcare

FEBRUARY 2, 2024

The Cigna Group beat the Street on both profit and revenue in the fourth quarter, where it reported $1 billion in earnings. | The Cigna Group beat the Street on both profit and revenue in the fourth quarter, where it reported $1 billion in earnings.

Hospital-backed proposal would make insurers reveal prior auth denial rates

Fierce Healthcare

FEBRUARY 1, 2024

A recommendation on the 2024 Measures Under Consideration list, brought forward by the Federation of American Hospitals (FAH), would add a quality measure in the Medicare Advantage (MA) star rating | The Federation of American Hospitals is pushing CMS for the inclusion of a star ratings quality measure that shows how often insurers overturn or uphold prior authorization denials.

Hospitals

Hospitals Medicare

Morgan Health: How employers can take the lead in addressing health equity

Fierce Healthcare

FEBRUARY 1, 2024

There are significant health disparities among people with employer coverage, but plan sponsors still have work to do to fully address those issues, according to a new analysis. | There are significant health disparities among people with employer coverage, but plan sponsors still have work to do to fully address those issues, according to a new analysis.

Industry Voices—PINning down better patient care: A closer look at CMS's decision to pay doctors for patient navigation services

Fierce Healthcare

JANUARY 18, 2024

Industry Voices—PINning down better patient care: A closer look at CMS's decision to pay doctors for patient navigation services hlandi Thu, 01/18/2024 - 15:18

Doctors

Financial distress fueled more hospital M&A deals in 2023, report finds

Fierce Healthcare

JANUARY 18, 2024

Hospitals’ immediate financial needs drove more than a quarter of the sector’s merger and acquisition activity through 2023, which also brought a higher overall number of unveiled transactions than | The portion of hospitals and health systems whose transactions followed dire financial situations was nearly double that of 2020, 2021 and 2022, Kaufman Hall wrote in a recent report.

Hospitals

CMS unveils new behavioral health model using a 'no wrong door' approach

Fierce Healthcare

JANUARY 18, 2024

The Centers for Medicare & Medicaid Services announced Thursday the Innovation in Behavioral Health Model, a new approach that is designed to test for improving outcomes for adults with mental | Continuing a Biden Administration priority, CMS released a new behavioral health model to improve outcomes for adults with mental illness or substance use disorder.

Medicaid

Medicaid Medicare

Business Group: These are the top healthcare challenges employers expect to face this year

Fierce Healthcare

JANUARY 18, 2024

Self-insured employers are set to face plenty of challenges this year, ranging from addressing the mental health needs of their workforces to developing strategies for on-site clinics amid a pivot | Mental health, pharmacy costs and vendor partnerships among the top healthcare concerns for large, self-insured employers, according to a report by the Business Group on Health.

Healthcare

Payer Roundup–Humana confirms layoffs; Medicaid expansion linked to lung cancer survival

Fierce Healthcare

JANUARY 18, 2024

Below is a round-up of payer-centric news for the week of Jan. 15., 2024 | This week, Humana announced workforce reductions, a study associated Medicaid expansion with reduced lung cancer mortality and Bright Health moved its corporate headquarters.

Medicaid

JPM24: Jefferson Health says LVHN merger would double its insurance business within 2 years

Fierce Healthcare

JANUARY 9, 2024

To diversify its revenue stream, the Philadelphia-based nonprofit wants to make health insurance a much larger part of its business.

Fierce Healthcare

Federal agencies open online portal for reporting anticompetitive practices in healthcare

AI medical assistants see rapid growth as health systems turn to tech as a cure for the burnout crisis

Trending Sources

Patient advocates shred Becerra’s copay accumulator comments during House hearing

30 health systems pursuing top-to-bottom age-friendly care with new collaborative

Elevance Health sees double-digit profit growth in Q1, posting $2.2B in earnings

Most doctors, consumers need transparency to trust generative AI in clinical decisions, survey finds

Providers pitch their post-Change cybersecurity policy fixes to sympathetic Congress

House to discuss national data privacy bill with implications for healthcare

Health equity has become an organizational priority as data capabilities slowly mature, EY finds

As Change reviews data impacted by cyberattack, here's what the notification process could look like

CMS limits scope, improves transparency of 'junk' plans in final rule

Hospital finances continue recovery in February, but Change Healthcare's full impact still on the horizon

Behavioral health company Forge Health looks to double down on payer, provider partnerships to serve complex medical patients

Walgreens takes $6B hit in Q2 from VillageMD investment

Revenue cycle management vendor R1 RCM receives $5.8B buyout offer from shareholder New Mountain Capital

b.well Connected Health raises $40M to scale platform unifying patient data

CarelonRx to launch weight management program with digital coaching

Steward Health Care shares recovery strategy but falls short of Massachusetts governor's documentation demands

Many disproportionate share hospitals face lower Medicaid payments under new final rule

Massachusetts 1115 waiver success can translate to New York: experts

UCHealth filed over 15,000 lawsuits against patients over 5 years, often under another name, report finds

'Podnosis': What are the healthcare sector’s sustainability needs?

Study: Chronic worker shortages in nursing homes must be addressed to help lessen patient risk

AT&T's 125,000 employees now have fertility, family building benefits through Maven Clinic

Health systems struggle to put AI governance policies in place to keep up with tech innovation

'New set of digital table stakes': Most executives see tech as worthy investment, EY survey finds

Chutes & Ladders—Spring Health hires new COO

Surprise billing disputes continue to far outpace federal estimates: CMS

Medication abortions over telehealth effective and safe, researchers share ahead of major SCOTUS case

Fierce Healthcare Fundraising Tracker—Ezra picks up $21M backed by Former One Medical CEO's VC

Papa’s New Impact Programs Add Value for Health Plans

Chutes & Ladders—Prominent Republican won't seek reelection

Virgin Pulse, HealthComp unveil rebrand as employer health company eyes accelerated growth

'Podnosis': Catching up with the Fierce 15 of 2019 (part 2)

Amazon cuts hundreds of jobs in One Medical, Pharmacy units

Cigna Group posts $1B in profit in Q4 earnings beat

Hospital-backed proposal would make insurers reveal prior auth denial rates

Morgan Health: How employers can take the lead in addressing health equity

Industry Voices—PINning down better patient care: A closer look at CMS's decision to pay doctors for patient navigation services

Financial distress fueled more hospital M&A deals in 2023, report finds

CMS unveils new behavioral health model using a 'no wrong door' approach

Business Group: These are the top healthcare challenges employers expect to face this year

Payer Roundup–Humana confirms layoffs; Medicaid expansion linked to lung cancer survival

JPM24: Jefferson Health says LVHN merger would double its insurance business within 2 years

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