News 6/21/24

Top News

An AMA physician survey finds that nearly 25% believe that prior authorization processes have caused a serious adverse event.

Two-thirds of respondents don’t believe that PA decision criteria are evidence-based. 

Nearly all of the respondents believe that prior authorization work increases physician burnout, with the average physician dealing with 43 PA requests per week that require 12 hours of physician and staff time.

One-fourth of respondents say their requests are often or always denied, while most believe that PA increases overall utilization as patients are forced to try ineffective treatments or to schedule more appointments because of PA-caused delays.

Reader Comments

From Former Nordic Exec: “Re: Nordic. I haven’t seen you report on the lawsuit that continues to impact the company’s leadership team.” I missed this item, although I admit that it doesn’t clear my interest hurdle. John Distefano sued Nordic Consulting Partners and now-retired CEO James Costanzo in February 2023, claiming that Nordic stole his software idea after he contracted with the company to develop and monetize it. The issue is murky because the parties signed various agreements as contractors and then with Distefano as an employee, which gives the company rights to anything an employee creates. Distefano created Wellward, which creates care plans from disconnected health and consumer information. The legal documents I’m able to view – as a litigation illiterate who doesn’t subscribe to PACER or other services – don’t paint a strong case, especially since it doesn’t seem that Nordic ever did anything with the software. I wouldn’t consider this item newsworthy unless a court rules against the company and mandates a big payout, nor would it seem to warrant a lot of executive concern. 

Webinars

June 26 (Wednesday) noon ET. “Population Risk Management in Action: Automating Clinical Workflows to Improve Medication Adherence.” Sponsor: DrFirst. Presenters: Colin Banas, MD, MHA, chief medical officer, DrFirst; Weston Blakeslee, PhD, VP of population health, DrFirst. What if you could measure and manage medication adherence in a way that would eliminate the burdens of medication history collection, patient identification, and prioritization? The presenters will describe how to use MedHx PRM’s new capabilities to harness the most complete medication history data on the market, benefit from near real-time medication data delivered within 24 hours, automatically build rosters of eligible patients, and identify gaps of care in seconds.

June 27 (Thursday) noon ET. “Snackable Summer Series, Session 1: The Intelligent Health Record.” Sponsor: Health Data Analytics Institute. This webinar will describe how HealthVision, HDAI’s Intelligent Health Management System, is transforming care across health systems and value-based care organizations. This 30-minute session will answer the question: what if you could see critical information from hundreds of EHR pages in a one-page patient chart and risk summary that serves the entire care team? We will tour the Spotlight, an easy-to-digest health profile and risk prediction tool. Session 2 will describe HDAI’s Intelligent Analytics solution, while Session 3 will tour HDAI’s Intelligent Workflow solution.

Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.

Acquisitions, Funding, Business, and Stock

Lifespan will rename itself to Brown University Health as part of a seven-year, $150 million Brown University investment in the health system.

Prior authorization technology vendor Humata Health raises a $25 million investment. Founder and CEO Jeremy Friese, MD, MBA, was co-founder and CEO at Verata Health. That company was acquired by now-defunct Olive AI in December 2020. Friese formed Humata Health to buy back the Verata PA assets from Olive in its wind-down.

Sales

• Deaconess Health System will provide 24×7 urgent care in all 50 states via virtual visits from KeyCare, which offers patients access from Epic MyChart. 
• HHS agency ARPA-H — the Advanced Research Projects Agency for Health — will use Palantir software to support its healthcare R&D efforts.

Announcements and Implementations

An EY survey of 56 health insurance executives finds that most believe that member experience has become more personalized — partly due to mobile apps, member portals, and telehealth – and member satisfaction increases when they have access to their own information. Most respondents tout the value of medical device wearables. The majority believe that digital health solutions can help reduce costs, but few of them have seen ROI.

Government and Politics

California’s attorney general co-sponsors proposed legislation that would allow require the office’s approval to complete private equity and hedge fund transactions in healthcare. The law could upend the business model that is known as Captive Professional Corporation or Friendly PC model, in which a clinician forms a professional corporation for billing but contracts with an outside company to provide services, thus avoiding conflicts with state laws that address the corporate practice of medicine. The issue is getting significant exposure in the investment and digital health communities through the reporting of Christina Farr, who believes that the legislation would have a major impact on digital health vendors.

Privacy and Security

The Russian hackers who launched a ransomware attack against UK-based pathology services vendor Synnovis have demanded a $50 million payment.

Other

Bizarre: a doctor and former elected official in Kenya who became a billionaire by opening hospitals sees his hospitals and his personal mansion set for the auction block after he is accused of using the hospitals as a front for his involvement with an international organ smuggling syndicate.

A food vlogger’s video titled “The Most Expensive Restaurant in America” draws millions of views, as Trigg Ferrano parodies his hospital stay. I wouldn’t deem it particularly clever or funny, but I feel that way for most YouTube videos whose goal seems to give people yet another way to waste time. I imagine it’s worse on Insta or TikTok, which I don’t use and haven’t installed.

Sponsor Updates

• Surescripts will implement the NCPDP SCRIPT Standard Version 2023011, Real-Time Prescription Benefit v13, and Formulary and Benefit v60 standards upgrades following publication of the CMS final rule.
• AvaSure hosts its Chief Nursing Executives Advisory Board in Nashville to share best practices for leveraging virtual care delivery models.
• Vyne Medical adds FormUSign, a new tool for automating electronic forms, to its Trace data workflow platform.
• Ellkay publishes a new customer success story featuring Lehigh Valley Health Network.
• Findhelp announces that benefits screening platform and case management system vendor Single Stop will add Findhelp’s hundreds of thousands of locations to its community resources map.
• CereCore will partner with FinThrive to deliver Revenue Cycle Management Technology Adoption Model (RCMTAM) consulting and advisory services to providers.
• Optimum Healthcare IT publishes a new case study titled “Epic Go-Live Success: Navigating a Cyber Outage at Guthrie Lourdes Hospital.”
• RLDatix CEO Jeff Surges will speak at the HFMA Annual Conference next week.
• FinThrive joins the Meditech Alliance Program, giving Meditech Expanse end users access to its Claims Manager and Access Coordinator Insurance Verifier solutions.
• Linus Health announces recent industry recognitions for its efforts to develop better tools for assessing cognitive function.
• MRO CEO Jason Brown wins EY’s Entrepreneur of the Year 2024 Greater Philadelphia Award.

Blog Posts

• New Five9 Data: AI in CX – It is not replacing humans (Five9)
• How a Continuous SOC Protects Healthcare Data (Fortified Health Security)
• Are You Confident in Your Health System’s Business Resilience? (Impact Advisors)
• Evaluating Impact of Medicare Cost Cap for Insulin on Patient Treatment (Inovalon)
• Medhost Q&A: Blue Ridge Medical Center’s Transition to Rural Emergency Hospital (Medhost)
• How ServiceNow Can Disrupt Healthcare – In a Good Way (Optimum Healthcare IT)
• Surveillance Collaborative breaks new ground with Meditech’s predictive analytics solution (Meditech)
• CMS Final Rule: Physical Therapy Medicare Guidelines for 2024 and Updates (Net Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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