Monday Morning Update 8/26/24

Top News

Publicly traded healthcare software vendor Evolent Health is reportedly considering acquisition offers from several private equity firms and insurer Elevance Health.

EVH shares are up 32% in the past year, having risen sharply since being down 44% in early July. The company’s market cap is nearly $4 billion. 

Reader Comments

From Poignant: “Re: Department of Justice looking at software algorithms for doing crime. Any chance that insurance companies might be looked at for using algorithms to issue denials and rejections?” It’s possible. One company that DoJ is looking at is RealPage, which it accuses of price-fixing in the apartment rental market by helping ling landlords set rent prices that the market will bear for 3 million apartments. DoJ says that practice thwarts competition via a coordinated effort, but RealPage says exactly the opposite in touting its ability to encourage competition. The issue and the pro-con arguments are nearly exactly the same as in healthcare payer cost management software vendor MultiPlan, which raises another red flag by taking a cut of the cost savings that are involved in recommending that payers underpay provider bills. The deputy attorney general implies that it’s a blurry line between analyzing market and competitor data to set prices versus colluding in a room: “Algorithms don’t exist in a law-free zone. Training a machine to break the law is still breaking the law.”

From Dirk Diggler: “Re: Epic and Vot-ER. Was that Epic integration announcement on Vot-ER’s site from April 2024? Wasn’t this an Epic April Fool’s phony item?” Here’s the Wayback link to the archived page. I’ve watched Epic’s April 1 announcement for years and I don’t remember this item, not to mention that it was on Vot-ER’s site and not Epic’s. The announcement mentions an “optional build” for Epic sites to integrate voter registration reminders from Vot-ER. Newsmax interviewed hard right Texas physician Kat Lindley, DO, who claims that Vot-ER provides “a script for undocumented patients on how to register to vote,” after which the host then claims that psychiatric hospitals are registering their patients and “potentially taking advantage of those folks for political purposes.” See below for Vot-ER’s response after reading the HIStalk mention last week.

HIStalk Announcements and Requests

Poll respondents chose the items above as most important in their decision to take a new job. Chosen by nearly none of them were advancement opportunities, a desirable relocation involved, and non-salary benefits. Bob noted that a valid option would have been seeking a job with a company where he could make a difference.

New poll to your right or here, tangentially related to last week’s poll: How does your company’s culture compare today to a year ago?

Welcome to new HIStalk Gold Sponsor CliniComp. The company is an innovative technology pioneer that has served customers globally for over 40 years with continual advancement in delivering a cutting-edge electronic health record (EHR) solution suite. CliniComp uniquely offers a System as a Service (SYaaS) model, eliminating the exorbitant cost of ownership with rapid deployment of all system components, hardware, software, and 24/7 support, as a complete package of services for the life of the customer. The company was selected in 2024 as winner for the “Best Electronic Health Record Service” in the MedTech Breakthrough Awards program, recognizing the breakthrough technology innovation of CliniComp’s SYaaS unique and superior model. The CliniComp solution is an integrated web-based EHR with an architectural framework conquering ever-evolving interoperability, scalability, adaptability, and real-time performance data challenges to provide a longitudinal patient record. Designed by clinicians for clinicians, CliniComp’s EHR provides an intuitive and seamless user interface and has earned an unrivaled record of performance and reliability with no planned downtime for decades in the most complex high-acuity hospital environments. Thanks to CliniComp for supporting HIStalk.

Webinars

September 10 (Tuesday) noon ET. “Overcoming Hurdles in Specialty Med Access Under Medical Benefits.” Sponsor: DrFirst. Presenters: Drew Hunsinger, VP of corporate business development, DrFirst; Tyler Wince, MEd, VP of product and technology specialty solutions, DrFirst. More specialty medications, which made up 80% of FDA’s new drug approvals last year, are falling under medical benefits, which challenges the patient care processes and efficiency of providers. Medication access experts will discuss how automation and unified medication management solutions can ensure better outcomes for patients and providers by addressing patient access hurdles and enhancing the ‘stickiness’ of EHRs. They will also provide insights into how regulatory changes such as interoperability and prior authorization mandates will affect healthcare stakeholders.

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

Cognizant-owned TriZetto sues Infosys, claiming that the company stole trade secrets related to TriZetto’s Facets and QNXT health insurance software .

Government and Politics

Vot-ER Executive Director Aliya Bhatia, MPP emailed me after seeing my mention of the Newsmax piece on Epic’s integration with Vot-ER. Her key points:

• Vot-ER is non-partisan. Its 350 health organization partners include the AMA and Penn Medicine.
• “The various claims in the Newsmax piece —  that non-citizens can register through Vot-ER (they can’t), that doctors ask about political affiliation (we forbid this), that Epic made an announcement about Vot-ER (they didn’t — we simply shared the modular addition that Epic customers can incorporate into Epic’s highly configurable system) — these claims are false. The technology we use asks eligibility questions that reject non-citizens and ensures only citizens complete registration. Additionally, in states where online registration is possible, we direct individuals to the Secretary of State websites which each have clear and strict eligibility guidelines.”
• The 1993 National Voter Registration Act encourages healthcare-based voter registration. Health systems are trusted venues that serve people who may have barriers accessing registration elsewhere.

Other

ProPublica asks 500 psychologists, psychiatrists, and therapists why they left health insurance networks, creating an artificial “shortage” in which half of insured Americans who have mental illness can’t access treatment unless they pay out of pocket:

• Insurance companies restricting coverage and delaying and/or denying treatment.
• The companies urge providers to reduce care even when their patients are suicidal.
• Providers struggled to stay in business as insurers paid months late or required endless hours of phone holds and faxed documentation. Some providers said they waited years for a check.
• Cigna outsourced its provider service work to a Philippines-based call center, where employees lack access to the company’s claims system and struggle with English medical terminology.
• Medicare pays mental health clinicians less than medical providers, resulting in physician assistants being paid 20% more than psychiatrists for the same office visit.

ED doctor Sam Ghali, MD notes the NewYork-Presbyterian-created Spotify playlist of 100 BPM, CPR-paced songs.

Sponsor Updates

• Nordic releases a new “Designing for Health” podcast, “Interview with Adam Carewe, MD.”
• The “Outcomes Rocket” podcast features Ann Louise Puopolo, chair of the customer advisory board at RLDatix, “The Future of Healthcare Staffing.”
• Waystar will exhibit at the EClinicalWorks Los Angeles Day Show August 28.
• VisiQuate celebrates its 15th anniversary.

Blog Posts

• Mastering Crisis Management: Tips for Mobilizing and Stabilizing Operations (Netsmart)
• Navigating health IT complexities with end-to-end solutions (Nordic)
• Evidence-based telehealth maximizes the potential of virtual care (Wolters Kluwer Health)
• Prominence Gives Back: Caitlin’s Day at the University of Michigan College of Health Sciences Summer Camp (Prominence Advisors)
• Total Economic Impact Report: How Rhapsody Delivers 193% ROI for Health Tech Teams (Rhapsody Health)
• 3 Payment Partner Questions with Rick Follett, Vice President, Partnerships at TrustCommerce (TrustCommerce)
• Cementing Trust: Our AI Commitment (Surescripts)
• What are the Risks of Poor Contract Management? (Symplr)
• Choosing the Right Claim Management Solution (TruBridge)
• Taming the data deluge: Driving effective member and provider data management with accurate identity (Verato)

Contacts

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