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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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QHIN Reactions at the ONC Annual Meeting

Healthcare IT Today

We previously shared ONC’s big QHIN announcement which shared the names of five officially designated QHINs as part of TEFCA: eHealth Exchange Epic Nexus Health Gorilla KONZA MedAllies No doubt, the timing of this announcement was planned to coincide with the ONC Annual Meeting in Washington DC. It was Healthcare IT Today’s first time attending the ONC Annual Meeting despite multiple years of FOMO for not attending.

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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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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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Northern Ireland HSC trusts sign with RLDatix for e-rostering

Digital Health News

All five acute Northern Ireland Health and Social Care Trusts have signed a deal with RLDatix for its e-rostering software.

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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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Rigor and Realism in Cybersecurity Strategy

HealthIT Answers

By Angela Fitzpatrick - Cyberattacks on healthcare organizations and their business associates continue to increase at an alarming rate, with nearly 500 breaches affecting 500 or more individuals each reported to the U.S. Department of Health and Human Services Office for Civil Rights between January and November 2023. The post Rigor and Realism in Cybersecurity Strategy appeared first on Health IT Answers.

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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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FBI disrupts healthcare ransomware group

Becker's Health IT

The Justice Department has taken down Blackcat ransomware group, the hackers behind the cyberattack on Allentown, Pa.-based Lehigh Valley Health Network.

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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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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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Florida hospital reports ransomware

Becker's Health IT

Bradenton, Fla.-based Manatee Memorial Hospital reported it was affected by a "sophisticated ransomware attack incident," according to the Bradenton Herald.

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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.