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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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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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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More Trending

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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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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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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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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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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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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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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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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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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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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 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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Holiday wishes for our beleaguered health-care system

Healthy Debate

Health-care workers and experts share their wishes for Canada's health-care system this holiday season.

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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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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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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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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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Healthcare AI News 12/20/23

HIStalk

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

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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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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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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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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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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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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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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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Readers Write: 2024 Regulatory Changes and their Impact

HIStalk

2024 Regulatory Changes and their ImpactBy Vatsala Kapur Vatsala Kapur,

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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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Morning Headlines 12/21/23

HIStalk

Get Well Announces Expansion Into Health Plans, Brings Health Plan.

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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.