Thu.Aug 17, 2023

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Blue Shield of California drops CVS Caremark in pharmacy benefit overhaul

Health Care Dive

BSCA has kicked CVS Caremark, the largest pharmacy benefit manager in the country, to the curb and is electing to carve out various pharmacy functions with companies like Amazon instead.

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Stanford Health CEO David Entwistle joins Redesign Health's board. Here's why he's bullish on digital health

Fierce Healthcare

David Entwistle has a storied career as a healthcare executive leading new innovations and steering strategic growth at academic medical centers. | Stanford Health Care CEO David Entwistle joined the board of directors at New York City-based Redesign Health. Here are the areas of healthcare he thinks are ripe for innovation.

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Ground ambulance billing committee skeptical of IDR process

Health Care Dive

A key congressional advisory group met on Wednesday to deliberate preventing unexpected bills after medical transport, but said the status quo dispute resolution process isn’t the solution.

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Blue Shield of California ditches CVS Caremark as PBM, unveils new pharmacy care model

Fierce Healthcare

Blue Shield of California today unveiled a new model for pharmacy care that it hopes will overhaul the “broken prescr | Blue Shield of California hopes to cut prescription drugs costs between 10% and 15%, or about $500 million a year, with an ambitious program that sidesteps the pharmacy benefit manager.

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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 Joint Commission and National Quality Forum announce affiliation

Health Care Dive

The groups claim their venture will tie the accreditation process more closely to data and outcomes, and won't lead to more quality measures for hospitals.

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Seniors believe Medicare needs overhaul but still feel entitled to current benefits

Fierce Healthcare

A recent survey from eHealth, an independent Medicare insurance adviser, released new data that shows 84% of respondents believe Medicare needs reform, but just 12% think changes should impact thei | A new survey shows that while seniors acknowledge Medicare reform is critical to the program's future, they expect to receive benefits at the cost they were promised.

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HOPCo Network Solutions partners with Florida value-based care network

Fierce Healthcare

Healthcare Outcomes Performance Company, a national leader in musculoskeletal practice and clinical outcomes management solutions, has partnered with Provider Network Solutions to establish a joint | Under a new joint venture with Provider Network Solutions (PNS) in Florida, HOPCo Network Solutions will add 1,100 new orthopedic, pain management and podiatry partners.

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Generative AI in healthcare: Google Cloud’s Amy Waldron on the tech giant’s health ambitions

Health Care Dive

Healthcare Dive caught up with Google Cloud’s Amy Waldron to discuss the technology giant’s plans — and the potential risks — for generative AI in healthcare.

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Mayo Clinic up nearly $1B as of 2023's midyear mark thanks to 'overperformance' of core operations

Fierce Healthcare

Mayo Clinic built on its solid first quarter with an even stronger $300 million fro | The nonprofit's six-month revenues are up 9.8% year over year, outpacing an 8.2% rise in expenses. For the second quarter, management attributed its nearly $4.5 billion total revenue to “overperformance in core operations as well as positive investment returns.

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Winning the Tech Cold War

The Rand Blog

Emerging technologies increasingly make it possible for machines to innovate much faster and more efficiently than humans ever could. The Pentagon can draw some important lessons for technology competition with China by looking at the U.S.-Soviet race to develop nuclear weapons during the Cold War.

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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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EDs are drowning under a rising number of pediatric behavioral health patients, providers warn

Fierce Healthcare

Amid warnings that emergency departments are not fully equipped to meet rising mental and behavioral health (MBH) needs of minors, a trio of healthcare professional organizations is calling for mor | Recent years have cemented emergency departments as critical access points and safety net care providers for kids with mental and behavioral health conditions.

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Building A Telemedicine Company – Challenges and Best Practices

HIT Consultant

Benjamin Katz. CEO and co-founder of Happy Head In the last few years, the healthcare industry has witnessed an explosion in both popularity and profits in a new sector of business. Thanks to the conditions brought about by the pandemic, telemedicine is now an increasingly popular format for diagnosing and treating a variety of conditions. Just a few years ago, the telemedicine market had a size of about $42 billion.

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PocketHealth launches in-app tool to surface follow-up instructions, boost compliance among patients

Fierce Healthcare

Pocket Health, a medical image-sharing platform, has launched a tool to help patients stay on top of their follow-up recommendations. | Whether the instructions are to schedule another appointment, tissue sampling or lab work, Follow-Up Navigator will surface them to the patient and prompt them to take action.

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Detecting Behavioral Health Fraud: How Health Plans Can Strengthen Their Approach

HIT Consultant

Erin Rutzler, VP of Fraud, Waste, and Abuse at Cotiviti As behavioral health claim volumes continue to increase, there’s a growing need for health plans to be vigilant in spotting fraud, waste and abuse. Today, the complexity and cost of these schemes necessitate a proactive, preventative approach. Nearly four out of five psychologists say they are seeing increased volumes of patients experiencing anxiety, while two out of three reported an increase in symptom severity in 2022, an American Psych

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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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Select Health, Kroger team on co-branded Medicare Advantage plans

Fierce Healthcare

Select Health is teaming up with grocer Kroger to launch new co-branded Medicare Advantage (MA) plans that aim to improve access to healthy food and affordable medications. | The new plans will first be offered in select counties across four states Select Health, a subsidiary of Intermountain Healthcare, serves: Colorado, Idaho, Utah and Nevada.

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24 Of The Fastest-Growing Companies Operating In Home-Based Care

Home Health Care

As home-based care continues to be the preferred care delivery method, it follows that companies delivering these services, as well as vendors in the space, would see growth as a result. With this in mind, it’s no surprise a number of companies working in the home health, home care, senior care and health care technology industries earned a spot on the latest Inc. 5000 list of America’s fastest-growing companies.

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Industry Voices—What time on the front lines of COVID taught me about how we should address the mental health crisis

Fierce Healthcare

As one of a small group of people working to develop and deploy COVID-19 testing at the very start of the pandemic, I witnessed both major blunders and genius breakthroughs, but what sticks with me | There are lessons we learned during the COVID-19 response that can and should inform our response to today’s record levels of depression, anxiety and other mental health conditions.

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Why Maternity Care Deserts Aren’t Going Away. Here’s What Can Be Done

HIT Consultant

Anish Sebastian, CEO and Co-founder, Babyscripts For a long time, healthcare providers in the U.S. have been putting band-aids on the problem of maternity care deserts , propping up existing services for pregnant women and new mothers with temporary fixes. The problem shows no sign of resolving, and it won’t until we recognize that the issues at its heart are not temporary.

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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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Industry Voices—It's time to prioritize behavioral health to achieve integrated healthcare

Fierce Healthcare

We have the opportunity to build and shape a healthcare industry that focuses on creating an integrated experience that is more cohesive and more patient-centered. | Carelon's integrated approach delivers the right care at the right time, giving people access to the full continuum of whole health services.

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VBC: Improving Healthcare Outcomes With A Strong Payer-Provider Relationship

HIT Consultant

Jonathan Malek, SVP and General Manager, Provider Business, Veradigm The last few years have emphasized the need for high-quality healthcare for patients that is accessible and affordable for all. There is tension between stakeholders in the healthcare industry surrounding efforts to keep costs low and increase revenue, while not sacrificing patient experience.

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OHSU to absorb struggling Legacy Health, form 10-hospital system

Fierce Healthcare

Two of Portland, Oregon’s leading healthcare providers announced plans Wednesday evening to merge and form a 10-hospital, $6.6 billion health system. | Should the nonprofits' deal close, the resulting system would pull more than $6 billion in annual revenue and become the largest employer in the Portland, Oregon, metro area. The agreement may come just in time for Legacy Health, which has been blunt about its financial struggles in recent years.

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Why Healthcare AI Must Maintain Multiple Layers of Specificity

HIT Consultant

Dr. Tamir Wolf, co-founder and CEO of Theator The recent explosion of generative AI has pushed public discourse to a palpable tipping point. Nearly overnight, it seems, we’ve cycled from “must develop and/or adopt new AI applications ASAP” to existential fear, avoidance, and even acrimony. For those of us who have been working directly in the artificial intelligence space for years, specifically in healthcare, these are both trying and exciting times.

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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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InterWell Health Capitalizing On Shift Of Speciality Care Heading Into The Home, Prioritizing Value-Based Contracting

Home Health Care

As more specialized care moves into the home setting, providers are strategically rushing to the front of the line to capitalize on the trend. InterWell Health – a business focused on at-home kidney care – is one such company. It also hopes to drive growth by adapting to a more value-based approach in the marketplace, its leadership told Home Health Care News.

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Inequities in exposure to copay accumulator programs

Healthcare ECONOMIST

Copay cards are somewhat controversial. These cards or coupons are used to help patients afford copayments and deductible payments patients owe when using pharmaceuticals. On the one hand, these programs are highly beneficial for patients. Patient out-of-pocket costs have risen dramatically in recent years, even among the insured. For instance, whereas only 7% of workers had a deductible of $2000 or more in 2009, now 32% have such a high deductible.

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Future Leader: Katie Davis, Senior Vice President, Clinical Operations, Vesta Healthcare

Home Health Care

The Future Leaders Awards program is brought to you in partnership with Homecare Homebase. The program is designed to recognize up-and-coming industry members who are shaping the next decade of home health, hospice care, senior housing, skilled nursing and behavioral health. To see this year’s Future Leaders, visit [link]. Katie Davis, senior vice president of clinical operations at Vesta Healthcare, has been named a 2023 Future Leader by Home Health Care News.

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How MEDITECH is driving AI innovations in health IT

Meditech

When considering how AI can be used in healthcare, it’s not simply a matter of identifying processes that computers can do faster than humans. The highly specialized and specific tasks performed within the field of medicine demand a thoughtful approach. At MEDITECH, our view of AI is driven by an understanding that its use within the EHR should safely enhance the experience for patients, care teams, and health systems.

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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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Inside Look at What’s Keeping Hospital Pharmacists Up at Night

PDC Healthcare

Key Takeaways from a Recent Pharmacy Survey PDC surveyed 6,400 Hospital Pharmacy Managers and Directors to get feedback on their priorities and challenges. Below we explore the results and key takeaways of the PDC survey, along with some helpful tips for pharmacy professionals. Top Concerns Among Hospital Pharmacists The top concerns identified by pharmacists were […] The post Inside Look at What’s Keeping Hospital Pharmacists Up at Night appeared first on connectID - PDC Healthcare Blog.

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New Africa CDC Legal Framework Helps Promote Infection Prevention and Control

CDC

The authors of this post co-led the development of the Africa CDC Legal Framework for Infection Prevention and Control. When we first began developing a strategy for Africa CDC to combat antimicrobial-resistant infections in Africa, we kept hearing the same message from people working in hospitals or in governments: no one gives us the authority or funding to stop infections in hospitals.

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5 Indicators Your Medical Contact Center Data Needs Organizing: A Sequence Health Guide

Sequence Health

In the healthcare sector, data management is not just a technical requirement but a critical factor that can make or break the quality of patient care. Disorganized data in call centers can lead to inefficiencies, poor patient experiences, and even medical errors. This article aims to shed light on the signs that your medical contact center data might be disorganized and how Sequence Health can help you turn things around. 1.

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Unite Us Launches New, Secure Chat Feature

HIT Consultant

What You Should Know: Unite Us, the nation’s leading software company enabling cross-sector collaboration to improve people’s health and well-being, launched Unite Us Chat: a new, secure chat feature that further drives the real-time collaboration required for whole-person care. The new functionality, built into the Unite Us Platform, and integrated with providers’ systems of record, allows users to communicate with other organizations in real time to coordinate care for people who need so

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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.