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Monday Morning Update 2/12/24

February 11, 2024 News 9 Comments

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The National Association of Accountable Care Organizations analyzes Medicare’s claims database to alert the federal government that 450,000 of its beneficiaries were billed for urinary catheters in 2023 versus the usual 50,000 in previous years, running up  $2 billion in suspicious charges.

Pretty in Pink Boutique — whose Medicare registration is for a house address in El Paso, TX and whose phone rings to an auto body shop — billed Medicare for at least $267 million in just over a year for catheters.

Patients and doctors who reported suspicious activity to CMS say they never got a response. Dozens of NYT commenters said the same, that the CMS person either expressed resignation with the status quo or lack of motivation to add to their workload.


Reader Comments

From Jerry Aldini: “Re: Oracle Health. Interesting comments on the Cerner Reddit.” Examples, all unverified:

  • “Oracle thought Cerner was worth buying for Larry’s little healthcare data hobby, but once everything is converted to OCI, nobody would ever want to buy what Cerner was ever again. So when Larry is no more or gets bored, it’s the end of the story.”
  • [On the company’s pledge to rewrite Millennium using AI] From everyone I’ve talked with, it is vaporware, and even then demos went to crap pretty quickly. I’m just riding this out until all clients abandon ship.”
  • “Maybe Congress would like to know more about Larry’s new wonderful AI software engineer and how it means that they can maintain a multi-billion-dollar system for America’s service people and veterans with nothing even remotely resembling what would be considered a normal software engineering company. Like, why bury the lede, Larry? You’ve successfully removed the need for high-cost, hard-to-find employees to maintain software. This is a coup for the entire tech industry. Forget the EMR, let’s hear about the AI, that’s where the money is.”

HIStalk Announcements and Requests

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Most poll respondents think that the former Cerner business has become less competitive since Oracle acquired it.

New poll to your right or here: Do you own shares or equity in a health IT-related company? You can use the poll’s comment function to describe times when you made or lost big money from a health IT investment.

Help me out by signing up for spam-free updates and connecting on LinkedIn.

I am an India-phile, fascinated with the culture, food, and business and technology advances of the world’s largest democracy. I also enjoy regional English usage. I collected these examples from HIStalk-related emails with people from India that featured words and terms that are accurate, just not commonly used here:

  • Prepone – the opposite of postpone, to describe moving an event earlier.
  • Revert back – not a redundant expression, but rather to ask for a reply, as in “kindly revert back.”
  • Cent percent – 100%.
  • Full stop – Indians were using this term long before trendy Americans embraced it in referring to the period at the end of a sentence, or to some, the more emphatic break at the end of a paragraph that signals a new train of thought.
  • Mention not – this is a great alternative to the wishy washy “you’re welcome.” I might start using this with hopes of displacing the dreaded “no problem,” although saying “mention not” after the person has already “mentioned” doesn’t quite fit.

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Welcome to new HIStalk Platinum Sponsor TruBridge. The Mobile, AL-based company connects providers, patients, and communities with innovative solutions to support financial and clinical solutions, creating real value in healthcare delivery. By offering technology-first solutions that address diverse communities’ needs, it promotes equitable access to quality care and foster positive outcomes. Its industry-leading HFMA Peer Reviewed RCM suite provides visibility that enhances productivity and supports the financial health of organizations across care settings. It champions end-to-end, data-driven patient journeys that support value-based care and improve outcomes and patient satisfaction. It supports efficient patient care with EHR products that integrate data between care settings. TruBridge clears the way for care. Thanks to TruBridge for supporting HIStalk.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.


Acquisitions, Funding, Business, and Stock

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Omnicell announces Q4 results: revenue down 13%, EPS –$0.32 versus –$0.64, beating Wall Street expectations for both. OMCL shares have lost 49% in the past 12 months versus the S&P 500’s 26% gain, valuing the company at $1.4 billion. The CFO said in the earnings call that customers are cautious about implementing new workflows because of IT and nursing staff shortages, while the CEO said that big health systems aren’t ready to implement innovation until they develop strategies for dispensing medication across their broad footprints.

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Virgin Pulse and HealthComp, which merged in November 2023, name the $3 billion business Personify Health.

Marathon Health, which bought Cerner’s employer occupational health clinics in August 2023, acquires Everside Health, expanding its services to 680 health centers in 41 states.

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Aptar Digital Health, a division of Aptar Pharma, will take over the digital health solutions of Biogen, which address neurological and rare diseases.


Sales

  • England’s Torbay and South Devon NHS Foundation Trusts chooses Epic.

People

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University of Tennessee Medical Center names Lynnette Clinton, MBA (BayCare) as SVP/CIO.


Announcements and Implementations

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Amenities Health launches plug-and-play provider search and scheduling for a health system’s public-facing website, extending its mobile app experience.

AdventHealth brings the last five of its 48 hospitals live on Epic, completing its conversion from Cerner. AdventHealth announced that it would implement Epic in early 2020, displacing the Cerner system that it had installed in 2002.

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Sparked, Australia’s national FHIR accelerator, opens the draft of its Australian Core Data for Interoperability Release 1 for comments.


Government and Politics

CMS tells Medicare Advantage insurers that they can use AI and algorithms to assist them in making coverage determinations, but they must make sure that the tools use complete information and they can’t use technology alone to deny hospital admission or downgrade to observation stay. CMS also warns that MA insurers should make sure that their systems are free of bias.

A North Carolina health news site observes that Atrium Health wields its status as a “unit of local government” to get tax breaks, the power of eminent domain, and anti-trust immunity that allowed it to acquire 40 hospitals in four states, after which it merged with Advocate Aurora Health to form the country’s third-largest non-profit health system with $27 billion in revenue.


Other

In India, a review finds that 11 of 40 of Bangalore tele-ICUs in rural “spoke hospitals” are not functional due to lack of Internet connectivity, lost software copies, and clinician shortages.

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Medical malpractice physician Jeff Willis, MD, MHA notes that 28 states give full practice authority to nurse practitioners and another 10 are considering it. He says that while the NP lobby was smart to take advantage of the primary care crisis to expand practice, he ponders that it’s a broken healthcare system that created the need and that it raises malpractice issues. A commenter says that several states also allow advanced practice chiropractors to do physician-like work, while another says that NPs are important in rural areas because doctors won’t work there given low volumes that drive RVU-based compensation. A physician commenter says that the rural idea sounds nice, except a lot of the NPs chase the money that comes from running IV bars, Botox shops, and med spas in urban areas.


Sponsor Updates

  • Kellum Medical Group (TX) leverages the Sunoh.ai AI medical scribe as part of its EClinicalWorks EHR implementation.
  • Amenities adds online patient scheduling to its Digital Front Door Platform.
  • Availity achieves the CAQH Committee on Operating Rules for Information Exchange (CORE) Eligibility & Benefits, Claim Status, Payment & Remittance, Prior Authorization & Referrals, and Health Care Claims Operating Certification seals.
  • Health Data Movers joins CHIME as a member.
  • QGenda and Spok will exhibit at the AHA Rural Health Care Leadership Conference February 11-14 in Orlando.
  • Waystar will exhibit at Nymbl.Con 2024 February 14-16 in Scottsdale, AZ.

Blog Posts


Contacts

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Currently there are "9 comments" on this Article:

  1. RE: CMS tells Medicare Advantage insurers that they can use AI and algorithms to assist them in making coverage determinations, but they must make sure that the tools use complete information and they can’t use technology alone to deny hospital admission or downgrade to observation stay. CMS also warns that MA insurers should make sure that their systems are free of bias.

    What could go wrong??? !!!

  2. “You’re welcome” is definitely NOT wishy-washy. It’s a much more professional response to the ever constant ‘Thank YOU” in response to a person’s expression of gratitude. To me, it’s hard to listen to that at the end of all the various on-air interviews.

    • I consider these things to be like verbal handshakes. It’s a socially accepted Done Thing.

      Person A: “Thank you”
      Person B: “You’re welcome”

      Don’t parse the words looking for deeper meanings. There are no deeper meanings. Person B is merely acknowledging Person A and their Thanks. That’s it.

      That’s why critiques of No Problem, KK, and No Worries are also off the mark. All of these responses mean nothing more than, “I heard your Thanks and accept them.”

      It’s like getting bent out of shape over the old Radio signoff, “Over and Out”. Over? What do you mean “Over”?? It’s not “Over” unless I say it’s Over!

      The thing is? If you strike out on your own and attempt to create a new socially acceptable Done Thing? You had better be flawless in your effort. And being charismatic would help a lot (and that often does not translate well in texts, e-mails, blogs, web pages, etc.).

      • The Aussie version is “No worries” and that’s much better. Let’s you off the hook for being in someone’s debt (which is what being thankful means) and ends the conversation

  3. AdventHealth changing 48 hospitals from Cerner to Epic in 2 years – can this be a blueprint for switching the VA to Epic as well?

  4. You know what has impressed me about Oracle buying Cerner? How little difference it has made.

    I thought that Oracle buying Cerner, would change Cerner’s trajectory. It now seems clear that it hasn’t done that.







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