Mon.Oct 02, 2023

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Cigna pays $172M to settle MA upcoding allegations

Healthcare Dive

The agreement settles a whistleblower lawsuit against Cigna that the Department of Justice joined last year, and requires the payer to undergo annual auditing from an independent entity.

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Building a Disability Organization Rooted in Disability Justice

Bill of Health

By Dom Kelly There’s a lot to say about the nonprofit sector and how it so often burns out, underpays, and devalues the humans who do the labor. There’s a pervasive narrative that this should just be accepted as a cost of doing good in the world. But for marginalized people who find themselves in this work for reasons that are connected to their identities, this kind of thinking ultimately pushes us out of the sector altogether.

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AHA urges lawmakers to roll back online tracking tech restrictions

Healthcare Dive

The hospital lobby argued recent guidance limiting third-party tracking technology prevents providers from sharing reliable healthcare information.

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Microsoft's Azure OpenAI Service is integrated into Mercy's offerings

Healthcare It News

The generative AI technology will supply patients with answers to healthcare-related questions and scheduling services and offer employees HR-related information.

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Navigating the Future: Generative AI, Application Analytics, and Data

Generative AI is upending the way product developers & end-users alike are interacting with data. Despite the potential of AI, many are left with questions about the future of product development: How will AI impact my business and contribute to its success? What can product managers and developers expect in the future with the widespread adoption of AI?

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Walgreens CIO Hsiao Wang out amidst C-suite shakeup

Healthcare Dive

The company has brought in seasoned exec Neal Sample to make "near-term" technology decisions, according to an email sent to employees.

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Women’s and Children’s Health Network launches Australia's first virtual gynaecological service

Healthcare IT News - Telehealth

SA Health has announced the launch of a new virtual care service for women needing urgent attention for their gynaecological concerns. Run by the Women’s and Children’s Health Network (WCHN), the virtual Women's Assessment Service will provide pregnant women across the state the option to receive an urgent assessment from an experienced midwife via video link.

More Trending

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Cigna to pay $172M to settle claims it overcharged Medicare Advantage program

Fierce Healthcare

Cigna will pay $172 million to settle allegations brought by a whistleblower and the U.S. | Cigna will pay $172 million to settle allegations brought by the U.S. government that it submitted false and inaccurate Medicare Advantage diagnostic codes in a bid to boost its reimbursement.

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Walgreens reportedly considering ex-Cigna exec for CEO

Healthcare Dive

The pharmacy giant is considering handing the reins to former Express Scripts and Evernorth CEO Tim Wentworth, according to Bloomberg, as Walgreens searches for a chief executive with deep healthcare experience.

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Digital health investments shift to disease treatment, workflow solutions and VBC in Q3: Rock Health

Fierce Healthcare

Digital health founders and investors continue to face a tighter funding cycle with fewer deals and lower check sizes. | In Q3 2023, U.S. digital health startups raised $2.5 billion across 119 deals, the second-lowest quarter by funding total since the fourth quarter of 2019, Rock Health reports.

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Cano Health appoints interim CFO

Healthcare Dive

Eladio Gil takes the reins as interim chief financial officer as the struggling primary care chain searches to replace Brian Koppy.

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Optimizing Medical Waste Management: A Guide to Best Practices

Feeling overwhelmed by medical waste regulations? This comprehensive guide unravels the complexities of medical waste disposal, ensuring you stay compliant and prioritize safety. Inside you'll find: Clear categorization: Learn to precisely classify medical waste for proper handling and disposal. Labeling & Storage: Discover best practices for clear labeling and secure storage of medical waste.

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Report: CMMI has raised federal spending, not lowered it

Fierce Healthcare

The Center for Medicare and Medicaid Innovation (CMMI), once expected to save money and deliver healthcare at a lower cost, is increasing federal spending after all. | CMMI was designed to reduce federal healthcare spending, but a new CBO reports shows its had the opposite effect. Some say this is the necessary outcome of embracing value-based care.

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Anthem, Bon Secours reach contract agreement through 2028

Healthcare Dive

The new contract puts to bed four years of tense network disputes between the Catholic health system and the Elevance subsidiary.

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Taking a page from consumer-facing tech, Providence launches startup to modernize patient engagement

Fierce Healthcare

Renton, Washington-based Providence launched a new startup to modernize patients' digital experience with the traditional healthcare system. | Health systems must take a page from the book of other consumer-facing industries, said Sara Vaezy, chief strategy and digital officer at Providence. The health system launched Praia Health to modernize patients' experience with the traditional healthcare system.

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How Technology can Address Clinician Shortage and Burnout

Healthcare IT Today

The following is a guest article by Kim Howard, Chief Client Officer at Nomad Health The U.S. healthcare system faces an estimated national deficit of more than 900K registered nurses by the end of the decade. Hospital CEOs agree that workforce challenges are the biggest issue they face, with 90% saying nursing shortages are the most pressing – a trend driven by the 4.7M healthcare workers retiring by 2030.

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How Embedded Analytics Gets You to Market Faster with a SAAS Offering

Start-ups & SMBs launching products quickly must bundle dashboards, reports, & self-service analytics into apps. Customers expect rapid value from your product (time-to-value), data security, and access to advanced capabilities. Traditional Business Intelligence (BI) tools can provide valuable data analysis capabilities, but they have a barrier to entry that can stop small and midsize businesses from capitalizing on them.

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Microsoft's Azure OpenAI Service is integrated into Mercy's offerings

Mobi Health News

The generative AI technology will supply patients with answers to healthcare-related questions and scheduling services and offer employees HR-related information.

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Independence Blue Cross touts enhanced Medicare Advantage offerings for 2024

Fierce Healthcare

Independence Blue Cross unveiled Medicare Advantage (MA) packages that the company said will greatly enhance benefits for its MA members, including a bigger allowance for vision, dental, hearing an | The MA enhancements touted by Independence Blue Cross include reducing premiums for its Personal Choice 65 PPO while including a Part B giveback and a bigger allowance for vision, dental, hearing and over-the-counter items.

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Health IT Potpourri – Healthcare IT Today Podcast Episode 124

Healthcare IT Today

For the 124th episode of the Healthcare IT Podcast , we are mixing together some of the recent health IT news with previews of some upcoming conferences to make our own little health IT potpourri! The first big news item we are discussing is UPMC and Intermountain moving to Epic. Then we discuss the acquisition of NextGen by Thoma Bravo. Lastly, we take a look forward and give a little preview of the upcoming HLTH and AHIMA conferences!

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AHA warns hospitals about data 'time bombs'

Becker's Health IT

Hospitals and health systems should be on the lookout for data "time bombs" that could cause patient information to be destroyed by hackers, the American Hospital Association warned.

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HIPAA Compliance: Can Your Organization Avoid Costly Government Penalties and Fines?

Colington Consulting was established in 2013 and helps organizations achieve HIPAA compliance and ensures clients stay current with the latest enforcement trends. We provide a full range of HIPAA compliance services and consulting. What separates us from our competitors is our knowledge of HIPAA compliance regulations and their application to each of our client’s particular scenarios and requirements.

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Ovum Health and IBM partner to tackle infertility with AI

Digital Health News

Fertility care provider Ovum Health has partnered with IBM to scale its web and mobile app-based chat and scheduling solution with AI.

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The Digital Dilemma: How Social Media Impacts Youth Mental Health and What We Can Do To Help

HIT Consultant

Lindsay Oberleitner, PhD, Education Director at SimplePractice In the current digital landscape, the impact of social media on youth mental health is becoming an increasingly pressing concern. Dr. Vivek Murthy, the U.S. Surgeon General, recently issued a call to action , urging tech companies and lawmakers to take immediate steps to safeguard the mental well-being of our children and adolescents.

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ACE and NHS AI Lab develop AI tool to improve hospital outcomes

Digital Health News

ACE and NHS AI Lab have collaborated to develop a tool that can identify those patients who are at risk of an extended hospital stay.

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5 Key Provider Enrollment Metrics You Can Use to Accelerate Revenue

MedTrainer

There’s no time to waste when providers are unable to generate revenue until they are enrolled with payers. Unfortunately, insurance payers have their own timeline and workflows. And while you can’t control their process, you can control yours. Provider enrollment metrics will help. Using your organization’s own data, you can better understand what is happening in your provider enrollment process and make changes to speed things up.

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Embedding BI: Architectural Considerations and Technical Requirements

While data platforms, artificial intelligence (AI), machine learning (ML), and programming platforms have evolved to leverage big data and streaming data, the front-end user experience has not kept up. Holding onto old BI technology while everything else moves forward is holding back organizations. Traditional Business Intelligence (BI) aren’t built for modern data platforms and don’t work on modern architectures.

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Nottingham Hospitals failed to send more than 400,000 letters – BBC

Digital Health News

Nottingham University Hospitals failed to send out 400,000 digital letters and documents to GPs and patients, BBC News reported Saturday.

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State Protections Against Medical Debt: A Look at Policies Across the U.S.

Center for Health Insurance Reform

Medical debt is one of the leading causes of bankruptcy in the United States. Though federal law provides some protection against medical debt and its downstream consequences, the federal framework has significant gaps. In a new report for the Commonwealth Fund, CHIR’s Maanasa Kona and Vrudhi Raimugia examine how states are filling gaps in federal law.

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mTuitive announces launch of mTuitive Insight to help tackle cancer

Digital Health News

mTuitive has launched mTuitive Insight to give power to structured cancer data and provide a view of this data for healthcare providers and researchers.

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Food-As-Medicine Grows Its Cred Across the Health/Care and Retail Ecosystem

Health Populi

In the nation’s search for spending smarter on health care, the U.S. could save at least $13 billion a year through deploying medically-tailored meals for people enrolled in Medicare, Medicaid, and private insurance programs, according to the True Cost of Food , research published by the Tufts School of Nutrition Science and Policy collaborating with The Rockefeller Foundation.

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Everything You Wanted to Know About FACIS, but Didn’t Know to Ask

Speaker: Amy Anderson

FACIS® helps organizations mitigate patient and organizational risk. Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. Most healthcare organizations screen and monitor providers against the OIG but that’s only ONE of FACIS®’ primary sources. FACIS® pulls data for every taxonomy from the lowest level employee to the highest level licensed professional.

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Amenities Health Closes Series A, Raising a Total of $10M to Modernize Health System Digital Front Doors

Healthcare IT Today

The New Financing will Accelerate Adoption of Amenities’ Groundbreaking Digital Front Door Platform Designed to Help Health Systems Improve Patient Loyalty Amenities Health , a leading Digital Front Door platform, today announced the final closing of its Series A financing round. The company secured an additional $6.25 million, putting Amenities’ total amount raised to date at $10 million.

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SCAN Health Plan cuts name-brand drug costs and starts women-oriented MA plan

Fierce Healthcare

SCAN Health Plan, a nonprofit health insurer specializing in Medicare Advantage (MA) offerings, is choosing to move faster than the government’s drug price negotiation timetable and is also offerin | SCAN Health Plan is launching a Medicare Advantage plan geared toward women and cutting 13 name-brand drug prices starting in 2024.

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Embracing Emotional Well-Being: Four Key Mental Health Trends

HealthIT Answers

By Dr. Bruce Bassi - In an increasingly digital world, individuals continue to turn to digital tools to address a wide range of challenges and concerns. Whether it's managing daily tasks, seeking information, or connecting with others, the integration of technology into our lives has become pervasive. The post Embracing Emotional Well-Being: Four Key Mental Health Trends appeared first on Health IT Answers.

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Systemic racism, nonstandard data collection hamper hospital equity officers' efforts, survey shows

Fierce Healthcare

An “early glimpse” into the work of hospital equity officers outlines a combination of internal and external roadblocks, including systemic racism, this new cadre of health system leaders face as t | Responses from hundreds of health systems' equity leaders outline a consensus that "racism, today, is a public health issue that cannot be adequately addressed in the vacuum of healthcare," but that hasn't stopped executives from trying.

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How to Leverage AI for Actionable Insights in BI, Data, and Analytics

In the rapidly-evolving world of embedded analytics and business intelligence, one important question has emerged at the forefront: How can you leverage artificial intelligence (AI) to enhance your application’s analytics capabilities? Imagine having an AI tool that answers your user’s questions with a deep understanding of the context in their business and applications, nuances of their industry, and unique challenges they face.