Thu.Mar 21, 2024

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Providers 'wasted' $10.6B in 2022 overturning claims denials, survey finds

Fierce Healthcare

More than 100 provider organizations want the Centers for Medicare & Medicaid Services (CMS) to take a tougher stance on Medicare Advantage (MA) plans’ practices following an industry survey es | Providers spent nearly $20 billion in 2022 pursuing delays and denials across all payer types, yet those efforts are substantially more costly on average when dealing with private plans, hundreds of hospitals and health systems told Premier in a recent survey.

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Consumers more discerning about health data sharing: survey

Health Care Dive

While respondents were largely willing to share their data, consumers have become pickier about who they’ll offer their information to, according to a Rock Health survey.

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Nvidia inks tie-ups with Abridge, GE HealthCare and Microsoft as it expands its footprint in healthcare AI

Fierce Healthcare

Chipmaker Nvidia sees big opportunities in healthcare AI and this week it launched more than two dozen new gen AI-powered microservices. | The global computing powerhouse inked collaborations with Abridge, Microsoft, GE HealthCare and Hippocratic AI to to expand its generative AI capabilities into healthcare and life sciences.

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Change Healthcare’s drawn-out recovery catches flak from cyber experts

Health Care Dive

At least 100 services remain offline four weeks after the UnitedHealth Group detected an intrusion in its medical claims clearinghouse. Experts say the impacts are unprecedented.

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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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WSJ: CMS broadens Part D coverage for obesity drugs

Fierce Healthcare

Medicare Part D may cover obesity drugs when they secure approval for additional, medically accepted uses, according to a WSJ report.

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Inpatient care experience gets a boost from telenursing and AI

Healthcare It News

Sensors and automation tech can allow nurses to interact with and monitor multiple hospital patients around the clock without entering their rooms or interrupting their sleep. Michael Brandofino, president and COO of Caregility, explains how.

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Walgreens’ VillageMD sells 11 locations in Rhode Island

Health Care Dive

The sale comes as the pharmacy chain culls VillageMD clinics, including in Florida and Illinois.

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Humana prioritizes veterans through Louisiana digital health partnership

Fierce Healthcare

Digital health company DUOS has developed a new program with Humana to care for Louisiana veterans with chronic conditions. | A new collaboration between Humana and digital health company DUOS will match Louisiana-based Medicare Advantage members to resources that treat chronic conditions.

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Hospitals could face revenue hit if insurers play hardball over MA: report

Health Care Dive

Insurers could increase claims denials and engage in aggressive contract negotiations with hospitals as profitability in the popular plans declines.

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Payer Roundup—UNOS under pressure from lawmakers; Prime Therapeutics allies with Capital Rx

Fierce Healthcare

Below is a roundup of payer-centric news for the week of March 18, 2024. | This week, the House Committee on Energy and Commerce is busy investigating the United Network for Organ Sharing and SAMHSA funding, a Centene subsidiary is helping hospitals pay for a health equity certification and Prime Therapeutics joins forces with Capital Rx.

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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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Artificial intelligence unpredictably impacts radiologist performance

Health IT Analytics

AI improves performance for some radiologists, but not others, raising questions about a one-size-fits-all integration approach for the tools in healthcare.

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Report Reveals Digital Diabetes Management Tools Fail to Deliver Benefits, Increase Costs

HIT Consultant

What You Should Know: – Digital diabetes management tools are failing to deliver meaningful health benefits to patients, according to a new evaluation by the Peterson Health Technology Institute (PHTI). – The report casts doubt on the effectiveness of widely used digital diabetes management tools. Despite billions in investment, the study finds these tools offer minimal health benefits and actually increase healthcare spending.

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Artificial Intelligence and Biotechnology: Risks and Opportunities

The Rand Blog

Machine learning is helping scientists make sense of the genetic keys that could unlock new crops, new drugs, and vaccines. But policymakers may not be prepared for the impact those two fields could have together. To make the most of the opportunities to come, and to avoid the dangers, that has to change.

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Discrepancies In Home Health Enrollment Data Raise Red Flags In Congressional Hearing

Home Health Care

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra fielded questions in a House Ways & Means committee hearing on Capitol Hill Wednesday, a few of which were pointed at concerns around potential fraud in home health. Rep. Michelle Steel (R-Calif.) grilled the secretary about an apparent lack of progress on curbing certifications for bad actors.

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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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Pharmacovigilance in Crisis: Automation as the Answer to Workforce Shortages

HIT Consultant

Scott Fonseca, Sr. Director of Business Development at IQVIA The healthcare industry is no stranger to workforce shortages, and the pharmaceutical industry may be next to experience disruptions brought on by labor challenges. According to the U.S. Bureau of Labor Statistics, it is estimated that occupations across life, physical and social sciences are expected to grow 7% by 2028.

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News 3/22/24

HIStalk

Top News Digital diabetes management solutions increase healthcare spending without.

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Chan Zuckerberg Initiative Forms AI Advisory Group & Residency Program to Develop Virtual Cell Models

HIT Consultant

What You Should Know: – The Chan Zuckerberg Initiative (CZI) announced the formation of a powerful AI Advisory Group and an in-house AI residency program, both focused on building predictive models of healthy and diseased cells – a key step towards creating virtual cell models. AI Advisory Group Background & Members CZI’s newly established AI Advisory Group will provide invaluable guidance and cross-disciplinary insights to CZI and the Chan Zuckerberg Biohub Network to push the b

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Achieving the right balance of human interaction and technology at your hospital contact center

Spok Inc

Gain essential insights into the best practices when creating an ideal human technology interaction for callers on the line. The post Achieving the right balance of human interaction and technology at your hospital contact center appeared first on Spok Inc.

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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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Deal Or No Deal: The Futures Of 3 Home-Based Care Companies

Home Health Care

This article is a part of your HHCN+ Membership Most buyers in home health and personal care are signaling they’ll be more active in the M&A market this year. That’s according to a new Mertz Taggart report , which included responses from over 50 potential home-based care buyers. Nearly 80% said they planned to be more acquisitive in 2024 compared to 2023.

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Syllable Acquires Healthcare CRM Intelligence Platform Actium Health

HIT Consultant

What You Should Know: Syllable , a leader in healthcare artificial intelligence and process automation, today announced its purchase of Actium Health. Financial details were not disclosed. As the industry evolves, health systems are faced with multiple challenges: Revenue growth with limited capacity, managing and retaining a highly-skilled, but burnt-out workforce, increasing operational costs, and making the most of their care delivery capacity to ensure patient access to high-quality care.

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Waud Capital Acquires Home Care Franchise Senior Helpers

Home Health Care

The private equity firm Waud Capital has acquired the home care franchise Senior Helpers. Advocate Aurora Health acquired Senior Helpers in 2021, with the idea that the health system would “own the full continuum.” A year and a half later, however, Advocate Aurora merged with Atrium Health , forming one of the largest health systems in the country. The health system is now offloading its primary home care asset to a private equity company that has become very active in home-based care of late. &

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Links

Healthcare ECONOMIST

FDA on AI. Rural hospital closures on maternal and infant health. Price caps for obesity drugs? One framework for fair drug pricing. Iterative approach to model-based decision making in health.

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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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Rimidi Care Network Launches to Increase Access to Remote Monitoring Services

HIT Consultant

What You Should Know: Rimidi, a market leading digital health company that supports healthcare providers in the delivery of remote patient monitoring and chronic disease management with EHR-integrated software, services, and connected devices, announced the launch of The Rimidi Care Network, a partnership program for remote monitoring clinical service providers.

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Alexandra Urrutia-Comas

Wisconsin Healthcare Leadership

Alexandra Urrutia-Comas, MHSA, FACHE, is a distinguished healthcare leader serving as the Vice President of Operations at Aurora St. Luke’s Medical Center, a prominent healthcare institution within Aurora Health Care, now part of Advocate Aurora Health. With a Master of Health Services Administration from the University of Michigan and a Bachelor of Arts in Health Administration and Policy from the University of Maryland Baltimore County, Alexandra possesses a robust educational background

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Conduce Health Secures $3M for Multi-Specialty Value-Based Care Marketplace

HIT Consultant

What You Should Know: – Conduce Health , a healthcare technology company focused on value-based care raises $3M in seed funding led by Connecticut Innovations with participation from AlleyCorp and CityLight. – With a network of over 150 specialists, Conduce provides a centralized platform for managing specialty care risk, optimizing contracting, and utilizing data science to deliver the right care at the right time.

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Keep Your Kids Safe: Put Medicines and Supplements, Including Gummies, Up and Away

CDC

National Poison Prevention Week (March 17-23, 2024) is a good time for parents and caregivers to review how medicines are stored in their homes. While you may keep prescription medicines Up and Away, and out of reach and sight of young children, it’s important to remember that over-the-counter medicines and supplements, such as vitamins and melatonin (including those in gummy form), should also be kept out of reach and sight.

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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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HIStalk Interviews Gene Scheurer, CEO, Optimum Healthcare IT

HIStalk

Gene Scheurer is co-founder and CEO of Optimum Healthcare IT.

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Interview with Julia Paget, Clinical Embryologist and IVF Guide CEO

Health Business Group

Alabama may be messing with IVF, but the procedure is alive and well in other parts of the planet. Guest, Julia Paget grew up on a farm on the Isle of Wight before embarking on a multi-national career as a clinical embryologist and entrepreneur. Navigating the world of IVF is no small feat, and Julia offers an honest look at the highs and lows of working within the fertility sector.

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EPtalk by Dr. Jayne 3/21/24

HIStalk

I’ve seen several recent mentions of Vale Health, which promises.

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Three Stories Illuminate How to Improve Health Equity

NCQA

NCQA Director of Health Equity Dr. Bryan O. Buckley ’s remarks to open day 2 of the Health Equity Forum were a highlight of that first-of-its kind event. Bryan highlighted three stories that taught him: Why health equity—giving everyone the chance at optimal health—matters. How to advance health equity. Visits to Grandma’s House Bryan’s first story involved visits to his grandmother, a teacher and school principal in an Antiguan village.

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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.