News 10/2/24

Top News

Private equity firm Accel KKR acquires VisiQuate, which offers revenue cycle analytics and workflow automation.

Reader Comments

From Slivovitz: “Re: Particle Health versus Epic. Particle may be unhappy about Epic’s behavior, but it’s a Hail Mary to claim antitrust behavior, which is rarely  successful.” Particle will need to prove not only that Epic holds a monopoly in the payer platform market, but also that it gained it through illegal means and that consumers were harmed as result. Courts often side with the antitrust defendant company’s business justification, and Epic has a strong one in protecting patient privacy. Epic always defends itself vigorously at whatever legal cost is required, making it unlikely that they will pay Particle to settle the lawsuit. Also to Particle’s disadvantage is that the Federal Trade Commission and Department of Justice are not involved, the lawsuit was not structured as a class action, and Particle’s complaint is mostly limited to itself, which doesn’t seem to be a strong antitrust argument. These cases often take years to resolve, so I assume that Particle’s business litigation law firm is working on contingency in hopes of earning a cut of any damages that Epic pays. The lead attorney represented AliveCor in its successful patent violation case against Apple.

Webinars

October 24 (Thursday) noon ET. “Preparing for HTI-2 Compliance: What EHR and Health IT Vendors Need to Know.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Tyler Higgins, senior director of product management, DrFirst. Failure to meet ASTP’s mandatory HTI-2 certification  and compliance standards could impose financial consequences on clients. The presenters will discuss the content and timelines of this key policy update, which includes NCPDP Script upgrades, mandatory support for electronic prior authorization, and real-time prescription benefit. They will offer insight into the impact on “Base EHR” qualifications and provide practical advice on aligning development roadmaps with these changes.

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

Acquisitions, Funding, Business, and Stock

Autonomous medical coding company Nym announces $47 million in new funding.

Private equity firm TPG takes a majority position in Surescripts, which hired an investment bank to search for potential buyers in April 2024.

CVS Health will lay off 2,900 employees and is reportedly considering breaking up the company’s businesses.

Sales

• Ballad Health (TN) selects oncology treatment and care management software and consulting and professional services from Varian, which Siemens Healthineers acquired in 2021 for $16 billion.
• Novant Health (NC) will implement data, analytics, and digital services from CitiusTech.
• Open Mind Health will incorporate NeuroFlow’s behavioral health technology into its virtual health and wellness services.

People

Ashley Blankette (Highmark Health) joins CAQH as chief product officer.

Jeff Pearson, MBA, MBL (Solis Mammography) joins Catalyst Health Group as CTO.

Announcements and Implementations

United Regional Health Care (TX) rolls out Care.ai virtual nursing technology in 16 emergency department rooms.

TidalHealth launches virtual nursing pilot programs at its Peninsula Regional and Nanticoke campuses.

Clearway Health launches a patient management system for specialty pharmacy programs that are operated by a health system.

My favorite big-picture healthcare analyst is Sanjula Jain, PhD, chief research officer of Trilliant Health. Her points from my March 2022 interview have aged well. Her new report highlights trends:

• The US health economy defies the laws of economics because employers have allowed the status quo to persist, have absolved state and federal governments from underpaying for healthcare services for Medicare and Medicaid enrollees, and via EMTALA have allowed the federal government to delegate responsibility for societal ills to hospitals.
• Value for money will be a defining trend of of the US health economy over the next decade. This is different from value-based care, which does not create value for the ultimate payer, such as the employer or federal government.
• The physical and mental health of Americans is deteriorating and the prevalence of chronic conditions is growing, even as the US spends more than other countries with worse results with costs growing, especially with Medicare.
• Healthcare administrative costs increased 40% to $278 billion from 2011 to 2021.
• HHS has been experimenting with value-based care for more than a decade and has implement other efforts to constrain costs, with limited effect on reducing cost or improving quality. CMS quality  measurement burden remains high and hospital quality reporting is expensive.
• Competition does not have a clear effect on hospital quality and negotiated rates are often lower in monopoly markets.
• Life sciences lobbying is 4.5 times that of other industries.
• The US pays 422% more for the same brand name prescription drugs than 33 other OECD countries.
• Use of CPT codes for AI indicates that its highest use is in cardiac conditions.
• Telehealth’s value as a clinical tool is limited. Patients don’t consider it a substitute for in-person care except for behavioral health, which accounts for 70% of telehealth volume.
• The shortage of primary care physicians could reach 40,000 by 2036.
• The average American doesn’t understand or use transparency efforts, which have had little impact on outpatient spending.
• Retailers have learned that delivering primary care is hard and running a specialty pharmacy is profitable.

A new KLAS report on population health management finds that health system interest has cooled considerably in recent years as they consolidate vendors and focus on value-based care. Arcadia is the most-considered solution. Systems from Lightbeam, Arcadia, Oracle Health, and HealthEC are most often being considered for replacement.

Government and Politics

The DoD’s Defense Health Agency is developing care delivery technology that will connect data and combat environments to MHS Genesis sometime next year, according to EHR optimization updates from the DHA.

The VA Inspector General and federal law enforcement are investigating at least 12 VA employees who violated HIPAA when they snooped into the medical files of veterans and vice-presidential nominees Senator JD Vance (R-OH) and Governor Tim Walz (D-MN) this past summer. Investigators are trying to determine if the records were shared and why the employees accessed the files. VA OIG found that the records are relatively easy to view because the system is set up to give quick access to doctors.

Privacy and Security

UMC Health (TX) continues to divert patients and utilize downtime procedures as it works to restore systems impacted by a ransomware attack that began last Thursday.

Other

Epic CEO Judy Faulkner, who at 81 says she isn’t planning to retire, tells Forbes how Epic will be run without her:

• Epic will remain private and her nearly 50% share of the company — along with all of Epic’s voting shares — will be moved to a trust that is run by her husband, three children, and five senior Epic managers.
• The rules of the trust prohibit an IPO, sale, or acquisition.
• Three long-time Epic customers will serve as trust protectors to make sure that the rules are followed.
• The next CEO will be required to be a long-term Epic employee who has software developer experience.

Oracle Health EVP Seema Verma disputes KLAS’s numbers on the company’s loss of customers to Epic, saying that Epic can’t solve major healthcare problems because its only offering is an EHR and that “KLAS’s short-sighted research” doesn’t reflect that.

Prisma Health opens a new convenience store using Amazon’s Just Walk Out technology at its Richland Hospital in South Carolina.

Sponsor Updates

• CereCore releases a new podcast, “Oklahoma Heart Hospital and Their 11-Month Epic Implementation.”
• Surescripts recognizes 10 healthcare organizations with its 2024 White Coat Awards for their leadership in performance, innovation, and accuracy.
• Artera introduces the 2024 Artera Heartie Award Winners.
• Ascom employees join Team Ascom to participate in the Great Cycle Challenge and raise money to help kids fight cancer.
• Medicomp Systems re-architects its Quippe solutions to meet W3C web component standards.
• TrustCommerce, a Sphere company announces that its next-generation Cloud Payments product has been certified on all major payment processing platforms.
• Capital Rx announces that its enterprise health platform, JUDI, has earned certified status by HITRUST for information security.
• Health Level Seven elects Clinical Architecture EVP of Client Services Carol Macumber chair-elect of its Board of Directors.
• CloudWave will exhibit and present at the Central and Southern Ohio HIMSS Chapter Fall Conference October 18 in Dublin, OH.
• Divurgent will present at the HIMSS Virginia Annual Conference October 15-16 in Williamsburg.

Blog Posts

• Best Practices: How To Solve IT Issues When EHRs Touch More People (CereCore)
• Agfa HealthCare showcases Interoperability Expertise at the IHE Europe 2024 Connectathon. (Agfa HealthCare)
• Key Takeaways from the FY 2025 ICD-10-CM Code Updates (AGS Health)
• Automate Your RCM Like the Portfolio Companies of Audax, Shore Capital, and TA Associates (Alpha II)
• Defeating Downtime with the Power of Cloud Hosting (Altera Digital Health)
• Fostering Payer-to-Payer Data Exchange Through Collaboration and Testing (Availity)
• Cultivating a Technology-Driven Revenue Cycle Through the Right Partnership (Cardamom Health)
• Perspective on the Proposed Health Infrastructure Security and Accountability Act (Clearwater)
• An Attackers’ Perspective on Cybersecurity Exploits (CloudWave)
• The Role of AI in Discovering New Medicines (Dimensional Insight)
• In the Next 10 Years, You May Wish You Had These Business-Related Skills (Direct Recruiters)
• Overcoming Hurdles in Specialty Medication Access: Key Insights From Our Recent Webinar (DrFirst)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.