Fri.Feb 25, 2022

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FTC seeks public comments on pharmacy benefit managers' impact on patients, pharmacies

Healthcare Dive

After a failed bid to launch a formal inquiry into PBMs, the FTC now says it wants to collect comments from the public to study a wide array of PBM practices.

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Vaccine credentials enabling wider progress on public health interoperability

Healthcare It News

First announced in January 2021, the Vaccine Credential Initiative – co-founded by MITRE Corporation and others including Cerner, Change Healthcare, Epic, Mayo Clinic, Microsoft, Oracle, Salesforce and others – has made big progress over the past year-plus on new approaches to interoperable record-keeping. The public and private partnership collaborated on developing a standard model for "trustworthy, traceable, verifiable, and universally recognized digital record of vaccinatio

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DOJ moves forward with suit to block UnitedHealth's acquisition of Change

Healthcare Dive

The lawsuit alleges that if UnitedHealth acquired Change, the payer would be able to gain a competitive advantage by seeing "very competitively sensitive" data from other insurers.

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Telehealth revenue could hit $20B in five years, say analysts

Healthcare IT News - Telehealth

A new report released this week from Bloomberg Intelligence predicted that the telehealth sector could bring in $20 billion in U.S. revenue by 2027. The Digital Reshaping the Health Care Ecosystem publication said that virtual care is set to "become a staple" of healthcare delivery. "The COVID-19 pandemic has accelerated the adoption of telehealth by years, providing safe and convenient access to telehealth services," said Duane Wright, senior research analyst at Bloomberg In

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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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Moderna bets on booster demand, advancing new 'bivalent' COVID-19 shot

Healthcare Dive

The biotech will start trials in the U.S. and U.K. of a vaccine that targets both the original coronavirus strain and the omicron variant.

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PrEP Coverage Obstacles Highlight Challenges Implementing the ACA Preventive Services Requirement

Center for Health Insurance Reform

The ACA requires coverage of recommended preventive services without cost-sharing for consumers enrolled in most private health plans. But even with these protections in place, some insurers improperly impose cost sharing for preventive services. Recently, this problem hit consumers who use pre-exposure prophylaxis (PrEP), a medication that can prevent contraction of HIV.

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More Trending

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Definitive Healthcare Acquires Analytical Wizards, Healthcare Analytics Platform

HIT Consultant

What You Should Know: – This week, Definite Healthcare announced the acquisition of Analytical Wizards , an advanced analytics company revolutionizing analytics in healthcare by combining our AI/ML-powered technology, domain expertise, and high-touch relationship model. Financial details of the acquisition were not disclosed. – Founded in 2015, Analytical Wizards automates complex analytic models using tools that expedite efficient big data mining using artificial intelligence (AI) a

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“I Have Too Many Pagers” – Fun Friday

Healthcare IT Today

Well everyone, we made it to Friday. Jim Samuel aptly tweeted “I just realized that today is Friday!” I feel the same. While it’s hard to find joy when there are countries at war, I think it’s also important to keep doing what we can to make the world a better place. So, here we […].

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WellSky announces plans to buy patient engagement tool TapCloud

Mobi Health News

TapCloud will bring its patient-facing app to WellSky's offerings.

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Health Catalyst Announces Intent to Acquire KPI Ninja

Healthcare IT Today

KPI Ninja to Bolster Health Catalyst’s Data Platform Capabilities, Maximize Functionality of Analytics Applications, and Speed-up Time-to-Value Health Catalyst, Inc. (“Health Catalyst,” Nasdaq: HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that it has entered into a definitive agreement to acquire KPI Ninja, a Lincoln, Nebraska-based provider […].

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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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Excluded Psychiatrist Results in Allegations of Violating the False Claims Act

Healthcare Compliance Blog

A Connecticut geriatric and adult psychiatry LLC and its owner have been accused of filing false claims. The allegations stem from accusations that the Connecticut psychiatry company and its owner employed a psychiatrist that was excluded from participating in all federal healthcare programs. In 2006, the excluded psychiatrist was convicted in Florida of conspiracy to commit healthcare fraud.

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Omada Health Closes $192 Million Series E Financing to Bring Virtual-First Care to Millions

Healthcare IT Today

Fidelity leads round to help Omada deliver on its mission to improve health outcomes for people living with chronic conditions Strategic financing will accelerate growth as the company expands its executive team and sees record market adoption Omada Health, a chronic care integrated healthcare provider, announced its $192 million Series E funding round led by […].

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Click inks deal with Altoida; Aflac, NeuroFlow team up on mental health and more digital health deals

Mobi Health News

Also: LifeStation and Papa collaborate on a social connectedness effort.

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We’ve Got You Covered With Background Screening

Verisys

Conducting employee background checks yourself? You could be missing important information that could protect your organization. For starters, background checks must be thorough. Which databases and primary sources do you check to ensure that you are getting a comprehensive history of your prospective hire? If you’re not verifying a candidate’s education, employment, and references, you could miss important clues about her past.

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The Big Payoff of Application Analytics

Outdated or absent analytics won’t cut it in today’s data-driven applications – not for your end users, your development team, or your business. That’s what drove the five companies in this e-book to change their approach to analytics. Download this e-book to learn about the unique problems each company faced and how they achieved huge returns beyond expectation by embedding analytics into applications.

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CVS Health Releases Drug Trend Report

HIT Consultant

What You Should Know: – CVS Health released their Drug Trend Report , examining the drivers of overall and specialty drug trend through the first three quarters of 2021. Data were calculated on a cohort of 1,014 PBM clients—employers and health plans—covering approximately 22 million lives. – The report details how CVS Health delivered an overall drug trend of 2.4% for commercial PBM clients, with 35.9% having a negative trend.

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2022 Healthcare Credentialing and COVID-19 Vaccines | symplr

Symplr

COVID-19 time line, February 2021: The distribution of COVID-19 vaccines was in its early stages. Fast forward to today: More than 200 million Americans are fully vaccinated against COVID-19 , which has gone a long way toward helping healthcare organizations safely resume normal operations and begin to recover financially. However, that number accounts for only 65% of the total U.S. population.

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Amino Launches its Healthcare Guidance Platform in Spanish

HIT Consultant

What You Should Know: – Amino , the leading employer-sponsored healthcare guidance platform, is adding Spanish Language capabilities and Mental Health providers. This will allow employees to easily find in-network mental health providers in either English or Spanish. – By guiding members to top mental health providers, Amino expands and accelerates access to high-quality, cost-effective mental health services, which can be difficult to find.

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RCM Tips to Improve Practice Collections

Medisys Compliance

Revenue Cycle Management (RCM) includes all activities directed toward receiving accurate patient and insurance reimbursements for delivered services. As most practices struggle with reduced practice collections and increasing expenses, we shared RCM tips that will help you to improve your practice collections. Reducing Claim Denials. Practices are struggling with ever increasing percentage of denied claims.

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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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GuideWell Becomes First U.S. Payer to Automate Prior Authorizations

HIT Consultant

What You Should Know: – GuideWell , one of the 10 largest health insurance providers in the U.S., became the first U.S. payer to automate prior authorization approvals through AI-powered clinical reviews from Olive , resulting in faster care for patients — up to 10 days faster — and greater provider satisfaction. – After launching a pilot with Olive in Florida, GuideWell saw its time to decision reduced by 10 days when immediate responses were available, decreased unnecessary prior a

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3 Reasons to Migrate to the Cloud with HIPAA Vault

HIPAA Vault

It’s been remarked about 18th century Vienna that Beethoven, Mozart, and Haydn all migrated to the great city for one, primary reason: they were drawn by the promise of something better, a dream of flourishing. Isn’t that what we all want? Whenever we hear the music of hope, we can imagine a brighter future. But, Continue reading.

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Viz.ai Awarded 510(k) Clearance for AI-Powered Cerebral Aneurysm Detection Solution

HIT Consultant

What You Should Know: – Viz.ai , a San Francisco-based provider of AI-powered intelligent care coordination for stroke, has received FDA 510(k) clearance for Viz ANEURYSM (formerly Viz ANX), the first and only AI-powered cerebral aneurysm detection solution designed to facilitate population screening and enhanced care management. – The new algorithm uses AI to detect suspected cerebral aneurysms, enabling hospital systems to ensure that once detected, patients are captured and the an

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HANYS reports detail hospitals’ economic and community impact

Hanys

Our annual Economic and Community Benefit Reports highlight the many measurable ways hospitals and health systems impact their communities. Share our webpage to highlight your organization's impact, and our video to demonstrate the impact of hospitals and health systems statewide.

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Monetizing Analytics Features

Think your customers will pay more for data visualizations in your application? Five years ago, they may have. But today, dashboards and visualizations have become table stakes. Turning analytics into a source of revenue means integrating advanced features in unique, hard-to-steal ways. Download this white paper to discover which features will differentiate your application and maximize the ROI of your analytics.

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Roundup: Bia Care teams with Imperial College to tackle inequalities, Digital screening campaign announced in the Netherlands, and more briefs

Mobi Health News

Also, Northern Ireland partners with Sectra to digitise pathology.

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Federal Court Strikes Down Qualified Payment Amount Presumption Under No Surprises Act Dispute Resolution Process

Hall Render

On February 23, 2022, the U.S. District Court for the Eastern District of Texas (the “Court”) vacated key portions of a regulation implementing the independent dispute resolution (“IDR”) process under the No Surprises Act (the “Act”). An interim final rule published in the Federal Register on October 7, 2021 (the “Rule”) implementing certain parts of the Act would have required Certified Independent Dispute Resolution Entities (“IDR Entities”) to employ a presumption in favor of the Qualifying P

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Accenture & Astellas Pharma Create Next-Generation Cloud-Based IT Core Platform

HIT Consultant

What You Should Know: – Accenture announced it helped Astellas Pharma Inc. create a cloud-based core IT platform that serves as the foundation for an advanced, data-driven management model for the company’s global operations, which has been rolled out in the Americas, EMEA and Japan, with plans for further deployments. – The new platform will help Astellas to rapidly incorporate new and emerging technologies; accommodate business expansions, such as mergers and acquisitions; accelera

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Have a Plan for Planned Giving: Funds Being Donated Not a Factor in Fraud and Abuse Analysis

Hall Render

On February 4, 2022, the Department of Health & Human Services Office of Inspector General (“OIG”) issued Advisory Opinion 22-02 protecting a children’s hospital’s donor-funded charity program (“Proposed Arrangement”). Under the Proposed Arrangement, the requestor (“Children’s Hospital”) would use funds from two individual donors to establish a restricted endowment fund that would subsidize patient bills for certain qualified families with children who have an established treatment relations

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Ensure Continuous Patient Care: How to Avoid Disruptions Due to Ransomware

The industry has seen an increasing pace of ransomware, zero-day, and remote-code execution attacks. Learn how to defend against these against these attacks in this eBook.

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DOJ sues to block UnitedHealth Group acquisition

Hanys

The civil lawsuit , filed by Department of Justice and Attorneys General of New York and Minnesota, intends to stop UnitedHealth Group from acquiring Change Healthcare in a proposed $13 billion transaction. The complaint alleges that the acquisition would eliminate Change as an independent firm, harming competition in both commercial health insurance markets and the market for technology used by health insurers to process insurance claims.

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Hall Render’s Health Provider News – February 25, 2022

Hall Render

NATIONAL. 40% of Nursing Home Residents Haven’t Received COVID-19 Boosters, Analysis Finds. 342 hospitals have received price transparency noncompliance notices from CMS. 3 states delaying booster mandates for healthcare workers. 23% of healthcare workers likely to leave healthcare soon, poll finds. AI in Healthcare Presents Need for Security, Privacy Standards.

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Texas judge strikes part of No Surprises Act

Hanys

The ruling strikes the regulation that governs how much insurers will pay to providers for disputed claims. The regulations stated that arbitrators of disputed claims should assume the correct amount for the insurer to pay is the median in-network rate for that geographic area, but the suit, filed by the Texas Medical Association and other doctors' group, argues that such a presumption violated the language of the NSA itself and did not include factors like the training and quality of doctors.

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Ventilator Consumables Market Analysis: COVID-19 Pandemic Repercussions

HIT Consultant

Consumables are often associated with low-cost, standardized products. This has often been the case with breathing system solutions used in ventilation. However, the COVID-19 pandemic has highlighted the importance of sufficient infection control in the hospital environment, subsequently uplifting demand for solutions that reduce infection risk. Vendors of all calibers grabbed this opportunity to expand market share, but questions remain on whether they will keep up in a crowded and price-sensit

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How To Package & Price Embedded Analytics

Just by embedding analytics, app owners can charge 24% more for their product. How much value could you add? This framework from Software Pricing Partners explains how application enhancements can extend your product offerings. You’ll learn: How to take a disciplined approach to pricing The three elements of the Packaging Decision Framework Ways to structure your new embedded analytics offering Download the White Paper to learn about How To Package & Price Embedded Analytics.