Wed.Dec 20, 2023

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UnitedHealth, OptumRx sued by independent pharmacy over ‘unconscionable’ fees

Healthcare 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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The SCOTUS Antibody Ruling Has an Uncertain Impact for Drug Makers and Patients

Bill of Health

How Amgen v. Sanofi will affect innovation and the pharmaceutical industry. By Timothy Bonis Millions of patients rely on monoclonal antibodies. The global market in 2022 was $210B with a compound annual growth rate of 11 percent. Monoclonal antibody patents are now some of the world’s most valuable intellectual property. Monoclonal antibody patent law has been in turmoil for the past two decades.

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Steward Health Care hit with False Claims Act lawsuit

Healthcare Dive

The suit alleges a Steward-run hospital improperly billed Medicare for more than 1,000 false claims.

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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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3 Reasons to Retire Pagers from Healthcare Settings

Let's discuss the trusty pager—an old favorite that’s losing its shine in hospitals and clinics. While once a staple in hospitals and clinics, pagers now present significant limitations that hinder rather than facilitate communication among healthcare professionals. Healthcare professionals are constantly on the move, and they need communication tools that can keep up with their fast-paced lives.

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Shared Savings Program linked to net losses in traditional Medicare, study finds

Healthcare Dive

However, the program was linked to savings in Medicare Advantage and for the CMS overall.

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More Trending

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Jefferson Health and Lehigh Valley Health Network announce intent to merge

Healthcare Dive

The deal would create a 30-hospital health system serving Pennsylvania and New Jersey.

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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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Featured Health IT Job: Epic PB and HB Claims Analyst

Healthcare IT Today

We like to regularly feature a healthcare IT job that might be of interest to readers. Today, we’re featuring the Epic PB and HB Claims Analyst position that was recently posted on Healthcare IT Central. This position was posted by Stoltenberg Consulting Inc. and is remote. Here’s a description of the position: Now seeking an Epic PB Claims and HB Claims certified analyst to support a client health system in Texas with claims and remittance build and troubleshooting, in coordination

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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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15 Modern Use Cases for Enterprise Business Intelligence

Large enterprises face unique challenges in optimizing their Business Intelligence (BI) output due to the sheer scale and complexity of their operations. Unlike smaller organizations, where basic BI features and simple dashboards might suffice, enterprises must manage vast amounts of data from diverse sources. What are the top modern BI use cases for enterprise businesses to help you get a leg up on the competition?

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Employer Direct Healthcare secures $92M, boosting valuation to $1B

Mobi Health News

The company announced the appointments of numerous individuals to its executive team and will use the funds to expand its partnerships and oncology platform.

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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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Not Just a Bill: The Importance of Empathy and Clarity in Healthcare Billing

HIT Consultant

Suman Chaudhuri, Vice President, CSG Forte When you leave the doctor, you’ll have a plan of care in hand. For instance, when you break an ankle, you may get instructions for the next 24 hours, a prescription, a follow-up appointment, a number to call if something goes wrong and a picture of what your next six weeks might look like. These plans are comprehensive and consider things like your activity level, the specific way your bone is broken, your ability to make it to appointments and any medi

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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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From Diagnosis to Delivery: How AI is Revolutionizing the Patient Experience

Speaker: Simran Kaur, Founder & CEO at Tattva Health Inc.

The healthcare landscape is being revolutionized by AI and cutting-edge digital technologies, reshaping how patients receive care and interact with providers. In this webinar led by Simran Kaur, we will explore how AI-driven solutions are enhancing patient communication, improving care quality, and empowering preventive and predictive medicine. You'll also learn how AI is streamlining healthcare processes, helping providers offer more efficient, personalized care and enabling faster, data-driven

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How tech can transform the delivery of oncology care

Digital Health News

Greater use of digital solutions could relieve the enormous pressure on cancer services, improve outcomes and personalise care, says consultant oncologist Penny Kechagioglou

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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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Iowa hospital caught in vendor breach

Becker's Health IT

Cedar Rapids, Iowa-based Mercy Medical Center's patient information has been compromised as its former medical transcription service, Perry Johnson & Associates, experienced a cybersecurity incident.

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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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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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Veterans Health Administration expands contract with AppliedVR

Mobi Health News

The award will support veterans' access to the California-based virtual reality company's FDA-authorized at-home chronic low back pain offering, RelieVRx.

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Why We Cannot Wait Any Longer: The Urgent Case for AI in Healthcare

HIT Consultant

Charles Aunger, Managing Director, Technology | Health2047 In Handel Jones’ literary alarm, “When AI Rules the World,” we are drawn to envision an age where AI doesn’t merely complement but dominates every strand of our societal fabric. One domain in dire need of this revolutionary touch is healthcare — a sector where the United States, alarmingly, trails behind in the global AI adoption race.

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Nervecentre is in right place at right time for digital transformation – CEO

Digital Health News

As more NHS junior doctors’ strikes take place, many health service staff and suppliers are looking at 2024 with trepidation. Not Nervecentre.

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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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Real-Life Examples of HIPAA Violations and How to Avoid Them

Speaker: Jack Clough, Chief Growth Officer

Download our 30-minute webinar where we delve into real-life examples of HIPAA violations and preventative measures every organization should know! You will learn: The critical factors that lead to HIPAA violations and how to identify them. Three compelling real-life cases of organizations that faced severe HIPAA penalties. Proven strategies to safeguard YOUR organization against HIPAA violations.

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Digital Health Coffee Time Briefing ? 

Digital Health News

Today's briefing includes a study looking at the efficacy of mobile health apps and news that ICSs are working with housing providers to improve healthcare.

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Will AI Continue to Demand All the Attention in 2024?

HealthIT Answers

Our annual predictions for 2024 continues with AI in 2024. Such a popular theme, stay tuned for Part 2 on Friday. Throughout the next few weeks we will be asking the industry experts what they think we will see in 2024. Check back as we cover value-based care, digital health, interoperability, privacy, security, access, and equality. The post Will AI Continue to Demand All the Attention in 2024?

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The Future of Healthcare: Integrated Data for Integrated Care

Healthcare IT Today

The following is a guest article by Venki Subramanian , SVP Product Management at Reltio When data is missing, inaccurate, incomplete, or misdirected, it can have severe, sometimes life-altering impacts. For example, in a survey by the Journal of the American Medical Association , approximately 1 in 5 patients who reviewed their electronic health record (EHR) ambulatory notes found an error–and 40% of these patients perceived the mistakes as serious, including mistakes in diagnoses, medical hist

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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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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.