Mon.Sep 09, 2024

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Biden admin mandates mental health parity in final rule

Fierce Healthcare

The Biden administration is strengthening private health coverage for individuals seeking mental health and substance use disorder (SUD) care in a final rule unveiled Monday. | The feds are attempting to better regulate mental health coverage by bolstering protections around prior authorization, step therapy and provider networks.

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CMS says data breach at contractor could affect more than 946K Medicare beneficiaries

Health Care Dive

The incident was related to a vulnerability in the MOVEit file transfer software, which was linked to data breaches at thousands of organizations last year.

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AppliedVR's flagship VR device for chronic lower back pain now in network for Highmark members

Fierce Healthcare

Pittsburgh-based Highmark has signed on as AppliedVR's first commercial payer partner, making its flagship VR device for chronic lower back pain a covered treatment for more than 4 million plan mem | Pittsburgh-based Highmark has signed on as AppliedVR's first commercial payer partner, making its flagship VR device for chronic lower back pain a covered treatment for more than 4 million plan members.

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Navigating government affairs in healthcare: Driving quality improvements

Health Care Dive

In healthcare, serving people is the real Job 1. But we can only do that job effectively through a relentless focus on quality.

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Fertility Benefits Playbook: How HR Leaders Are Delivering Value in 2025

Speaker: Kaitlin Ruby Carroll

Fertility benefits have become a crucial component of employee well-being and retention strategies. In today’s competitive landscape, creating a fertility benefits program that aligns with both employee needs and organizational goals can be more complex than it seems. From cycle-based to flat-dollar and telehealth models, each solution offers unique advantages and challenges that directly affect employee satisfaction and financial well-being.

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AMA study: The 4 largest PBMs control 70% of the market nationally

Fierce Healthcare

The four largest pharmacy benefit managers in the U.S. | The four largest pharmacy benefit managers in the United States control 70% of the national market, according to new data from the American Medical Association.

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Rite Aid emerges from bankruptcy with $2.5B in exit financing and a new CEO at the helm

Fierce Healthcare

Retail pharmacy chain Rite Aid has emerged out of bankruptcy after slashing about $2 billion from its debt, the company announced last week. | Retail pharmacy chain Rite Aid has emerged out of bankruptcy after slashing about $2 billion from its debt, the company announced last week.

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The release of the WAIS-5 provides richer detail and more nuanced information while retaining historic reliability

Health Care Dive

Explore the new WAIS-5’s advanced features and applications across various settings.

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Texas sues HHS over rule that limits access to reproductive health information by law enforcement

Fierce Healthcare

The state of Texas is suing the Department of Health and Human Services in a Texas federal district court for a rule it finalized in April that gives healthcare organizations more discret | The state of Texas filed a lawsuit last week that argues a rule finalized by HHS' Office for Civil Rights is illegal. The Texas attorney general says HHS does not have statutory authority to keep information from law enforcement.

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Elevance expands ACA plans in Florida, Texas, Maryland

Health Care Dive

The insurer’s Wellpoint subsidiary is expanding its ACA footprint for the 2025 coverage year, likely in a bid to capture enrollees who recently lost Medicaid coverage.

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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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Hospitals, health systems' labor crunch continues to fade

Fierce Healthcare

Labor costs and availability were major pain points for hospital and health system operations during the pandemic but finally look to be leveling out even as demand for care services remains high, | Though post-pandemic demand and an aging population are still at play, hospitals and health systems have made gains on rampant wage inflation and job openings during the past year, Fitch Ratings wrote in a new report.

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The importance of data quality in realizing value from medical imaging data

Health Care Dive

Realize the potential of medical imaging data: how Enlitic's data quality solutions drive optimization.

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Increased claims denials, staff shortages worry health system rev cycle heads, survey finds

Fierce Healthcare

Health system executives in charge of their organization’s revenue cycle are fretting about their dealings with payers, with many noting elevated denial rates across the board and within Medicare A | Forty-one percent of surveyed revenue cycle leaders report denial rates higher than 3.1%, and nearly all describe payer challenges as a top concern.

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The Imperative to Stay the Course on Value-Based Transformation

HIT Consultant

Courtney Fortner, President and Chief Executive Officer at Navvis Is value-based care still the right strategy to reduce U.S. healthcare costs? Or is it time to move to what comes next in the generation-long battle to constrain total medical spending? The question is being increasingly asked and with good reason. For 2024 medical costs are projected to rise 7.0% year over year for Individual and Group markets.

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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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The Fierce 50 of 2024

Fierce Healthcare

I’m honored to introduce the second edition of the Fierce 50, where we once again spotli | In this year's Fierce 50 special report, we are highlighting the innovators and leaders who are shaping the future of healthcare, pharma and biotechnology. This year's honorees demonstrate unwavering dedication and creativity, propelling these industries forward.

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Withings Sleep Rx Receives FDA Clearance for Home Sleep Apnea Testing

HIT Consultant

What You Should Know: – Withings , a global leader in connected health, has announced that its Sleep Rx sleep apnea device has received clearance from the U.S. Food and Drug Administration (FDA). – Sleep Rx represents a significant advancement in the diagnosis of sleep apnea, offering a more convenient and accurate alternative to traditional in-lab testing.

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A look at the evolving needs of practice management

Fierce Healthcare

Healthcare providers of all sizes are feeling the impact of burnout, time constraints, a | In this week's episode of "Podnosis," we look at how practice management companies are meeting the evolving needs of healthcare providers.

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North Korea Explained: What Americans Need to Know

The Rand Blog

The Korean Peninsula will demand a nuanced strategy from the incoming U.S. administration. Two RAND experts discuss foreign policy challenges, denuclearization, and bolstering the U.S.–South Korea alliance, as well as cybersecurity threats, economic sanctions, and human rights abuses in the region.

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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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Highmark Covers AppliedVR’s RelieVRx for Chronic Back Pain

HIT Consultant

What You Should Know: – Highmark , a commercial health insurance plan, has announced coverage for RelieVRx , a virtual reality-based therapy for chronic low back pain. – This landmark decision makes RelieVRx accessible to over four million Highmark members. A Breakthrough Treatment for Chronic Back Pain RelieVRx is a fully immersive VR experience designed to empower individuals with skills for managing chronic low back pain (CLBP).

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For Home Health Providers, Getting The ‘Right Person’ At The Table Is Crucial In Medicare Advantage Negotiations

Home Health Care

While getting a fair rate is top of mind for home health providers, the ones that are seeing the most success in their negotiations with Medicare Advantage (MA) payers are selling their ability to be a solution. Even before entering negotiations with MA plans, providers should have a clear understanding of the challenging reimbursement environment they are walking into, according to Fred Bentley, managing director at the research and advisory firm ATI Advisory.

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Breaking the Vicious Cycle of Hospital Staffing

HIT Consultant

Matt Dane, Senior Vice President, Business Development, Hallmark Health Care Solutions The healthcare labor market is in the middle of a fundamental shift. Healthcare workers are looking for greater flexibility and balance when it comes to their working arrangements, which poses significant challenges for nurse recruitment and retention. At the same time, traditional staffing models employed by large healthcare providers, which have heavily relied on staffing agencies to fill labor gaps, have pr

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Home Health Leaders Found Guilty In $5M Fraud Scheme 

Home Health Care

A Detroit-area couple who owned home health care companies was sentenced to prison last week for Medicare fraud and tax evasion, according to U.S. Attorney Dawn Ison. Noli and Isabel Tcruz of Washington Township, Michigan, were sentenced on Sept. 4. Noli Tcruz received six years in prison, and his wife was given three years and two months. The Tcruzes were convicted and sentenced for schemes related to their operation of several Macomb County home health care companies.

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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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Russia Explained: What Americans Need to Know

The Rand Blog

Among the many international issues confronting the candidates for U.S. president and the American electorate in this fall's election is the U.S. strategic posture with regard to Russia, its aggression against Ukraine, and the policies of its leader, Vladimir Putin. Two RAND experts explore a range of critical issues that will confront the next president.

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Medicare Advantage Plans Are Contracting Heading Into 2025

Home Health Care

Humana Inc. (NYSE: HUM) will be exiting 13 Medicare Advantage (MA) markets in 2025, company leaders said during the Wells Fargo Healthcare Conference. The company had already announced that it was planning to leave markets next year, but offered up more specifics last week. Humana CFO Susan Diamond said the company’s exit from those 13 markets would affect about 560,000 members, or around 10% of its individual MA membership base.

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Who was Harold Hotelling?

Healthcare ECONOMIST

Who was Harold Hotelling and what did he contribute to the field of economics? A paper by Gaspard et al. (2024) in the Journal of Economics Literature provides some background on his life, his research and pros and cons of his research contributions. Today I summarize some of his key contributions to the field of economics. Spatial Competition Model (Hotelling Law) Hotelling’s most famous contribution is likely his 1929 paper ( Hotelling 1929 ) on spatial competition, which introduced what

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Updated TEFCA SOPs for Health Care Operations and NCQA

NCQA

NCQA is encouraged by the expansion of TEFCA (Trusted Exchange Framework and Common Agreement) and its potential to enhance national health outcomes through timely data exchange. The recent inclusion of HEDIS ® reporting as a Level 2 exchange purpose in two standard operating procedures under TEFCA highlights the industry’s dedication to leveraging interoperable health data for digital quality measurement.

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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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Holland & Knight Health Dose: September 10, 2024

HKLaw

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector.

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Apple Launches AirPods Pro 2: All-in-One Hearing Health Experience

HIT Consultant

What You Should Know: – Apple has introduced a groundbreaking new feature for AirPods Pro 2: the world’s first end-to-end hearing health experience. – The innovative solution combines a scientifically validated Hearing Test with a clinical-grade Hearing Aid capability, providing users with a comprehensive tool for managing their hearing health.

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Curbside Consult with Dr. Jayne 9/9/24

HIStalk

As I work on optimization projects with different care delivery.

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