Monday Morning Update 3/11/24

Top News

UnitedHealth Group hopes to restore Change Healthcare’s electronic payments systems by March 15 and its medical claims platform the week of March 18.  The company says that e-prescribing and pharmacy claims and payments came back online on March 7.

UHG has suspended some of its requirements through March 31: (a) prior authorization for Medicare Advantage plans; (b) utilization review for MA admissions; and (c) drug formulary review for Medicare Part D. 

The company says that recommends that providers use multiple paths and workarounds for submitting claims, noting that, “If there’s anything we’ve learned as an industry, it’s that system redundancy is critical.” It acknowledges that some of the temporary workarounds will lack full edits and functionality, which could require rework.

The hacker who claimed to provide the BlackCat ransomware group as an a ransomware-as-a-service “affiliate” may be associated with China-base cybercrime syndicates, according to a security group that spoke to the hacker “Notchy,” who claims that BlackCat stiffed them of the 90% commission due on the $22 million ransom that UHG supposedly paid.

CMS, which initially announced plans to offer financial assistance to Medicare Part A providers (hospitals) who are experiencing claims disruption, expanded the plan to include Medicare Part B providers (physician practices).

Reader Comments

From HSA Card User: “Re: credit card. Some practices are charging for paying by credit cards, even HSA cards. Apparently processing fees are being passed to practices that are then passing them along to patients.” Charging extra to cover the cost of processing a customer’s credit card seems to be a lot more common lately, especially among restaurants that previously preferred it over managing a drawer full of cash. Some business have gone card-only. My questions in all such cases are: (a) what customer behavior are you trying to encourage?; and (b) are you willing to annoy and potentially lose customers who wouldn’t even notice a slight price bump, but resent the heck out of a separate charge for using plastic? It’s galling enough for a $15 burrito, but a $2,000 co-pay means donating maybe $60 for the privilege of giving the practice your money.

From Sunshine Superman: “Re: Children’s Minnesota. See this supposed Oracle Health insider’s comments.” The anonymous, unverified poster says that 97% of the Children’s Minnesota participants who sat through presentations from Epic and Oracle Health voted to replace Cerner after 26 years at a cost of $200 million:

Oracle Health’s approach was to admit how much they screwed up over the years and how Oracle has so much more technical talent compared to Cerner to get things done right / quickly. They couldn’t actually give any sort of commitments on what they would do to make things right other than their same BS vaporware that something great will be coming soon. Meanwhile, Epic did a full presentation on their current solutions and the future plans.

HIStalk Announcements and Requests

Summarized comments from a nearly even poll vote on whether Epic is a monopoly:

• It would be a stronger “not a monopoly” vote if Epic didn’t charge fees for client-chosen third parties to access its APIs.
• Those so say Epic is a monopoly may have competed against Epic and lost or feel that Epic doesn’t give their companies enough integration options.
• Epic is the safest purchase for CIOs, although struggling health systems must be challenged to justify the cost of Epic to their boards.
• Epic saw where the market was going, built all its own products, and figured out how to train new college grads to provide the large number of employees needed. Perhaps allowing health systems to resell Epic to small hospitals and clinics is questionable, but of all of healthcare’s monopolistic behaviors, Epic isn’t the real problem.
• The company’s business practices thwart innovation by third parties, although that isn’t a legal monopoly.
• Epic’s market share in academic medical centers meets the monopoly threshold of 50%.
• Weak competitors, such as Eclipsys and McKessonHBOC, limited a prospect’s choice, and the competition seems to be getting weaker.
• Mid-sized and smaller hospitals choosing Epic because it has a monopoly on interoperability, which is 100% a monopolistic practice. CIOs of any health systems under 500 beds will tell you that’s why they chose it.
• CEO Judy Faulkner greased the wheel of Washington by serving on the federal health IT policy panel.
• Just because something is dominant doesn’t make it a monopoly, and the DoD’s bake-off didn’t result in selecting Epic. A natural monopoly where it’s more efficient and effective for customers to have a single provider is sometimes a good thing.

New poll to your right or here: Have you scheduled an in-person medical visit purely online in the past year? Sending a request message and waiting for a return email or call doesn’t count – you have to have booked completely in real time using just your keyboard.

I don’t bury you with teacher updates from the Donors Choose projects that were funded by reader donations, but Ms. W from New York City checked in after she started using the STEM building kits we provided for just a $60 reader donation (Con Edison matched half of the $234 total cost, while my Anonymous Vendor Executive matched half of the remaining half):

I’ve seen academic benefits and positive social changes in my students. Building the kits required my students to use teamwork and collaboration as they worked together to connect the pieces. Your thoughtful contribution has improved their science knowledge and helped build friendships and communication skills. Thank you for making a lasting impact on my students’ learning journey.

Webinars

March 27 (Wednesday) 3 ET. “Houston Methodist: Deploying clinical AI at scale for improved outcomes.” Sponsor: Health Data Analytics Institute. Presenters: Khurram Nasir, MD, MPH, chief of cardiovascular disease prevention and wellness, Houston Methodist DeBakey Heart & Vascular Center; Brenda Campbell, RN, senior consultant, HM Health System Innovations; Nassib Chamoun, MS, founder and CEO, HDAI. The presenters  will share how an interdisciplinary team collaborated to successfully use predictive models and a novel AI-driven approach to address post-discharge mortality. They will also describe how they expanded use of the platform to reduce clinician time spent digging through the EHR with a one-page risk profile, including codes extracted from notes using generative AI, and targeting their highest risk patients for extra attention. They will speak to how they overcame barriers to bringing AI at scale to support clinicians across the care continuum.

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

Sales

• WellSpan Health will implement Nuance’s DAX Copilot, embedded in Epic.

People

Kulwant Gill (KPMG) joins Pivot Point Consulting, A Vaco Company as SVP of management consulting.

RadiantGraph hires Geeta Nayyar, MD, MBA (Salesforce) as chief medical officer.

Announcements and Implementations

Emory Healthcare goes live on Epic on MacBook Air via Epic’s just-announced native Hyperspace app that is available in the Mac App Store. The health system expects to save $300 per device pear year in licensing and support costs by running on Macs instead of PCs.

Rhapsody announces Autopilot, an AI-powered patient linking solution that it says boosts people-based identity resolution from 72% to 85% consistency to 98%. 

Albany Medical Center (NY) goes live on Epic, the first of Albany Med Health System’s four hospitals that will implement Epic.

Government and Politics

DoD goes live on Oracle Health in the Lovell FHCC that it operates in conjunction with the VA. The DoD’s MHS Genesis is now live at every DoD domestic and international site. The VA, which paused its rollout after going live at five of its 170 medical centers, says that Lovell’s results will drive its decision to restart its implementation.

Sponsor Updates

• KLAS Research names AGS Health the most improved services solution in its “2024 Best in KLAS – Software & Services” report.
• Nuance and Providence are working to accelerate AI innovation at scale, propel in-house solutions development, advance clinical research, and spur further collaborations between health systems and health IT vendors.
• Nordic Consulting and SupraNet Communications extend their partnership to offer unlimited free WiFi services at Dane County Regional Airport in Madison, WI.
• ServiceNow names Optimum Healthcare IT Senior Developer Elijah Aromola a 2024 ServiceNow MVP for the fifth year in a row.
• The Customerland Podcast features SmartSense VP of Customer Success Danny Keough, “Elevating Customer Success with IoT.”
• SnapCare wins the Best Use of Technology Award during the 2024 Tiara Staffing Awards.
• Sphere’s TrustCommerce integrates with PayPal and Venmo to offer more flexible payment options to patients.
• The FinnVoices Podcast features TruBridge Chief People Officer Amaris McComas, “Preparing the Healthcare Workforce for AI: Time to Build Culture, Upskill, and Invest.”
• Visage Imaging offers a new case study, “Accelerating PACS on AWS with Visage Imaging.”

Blog Posts

• FTE vs. Fractional: What’s the Right Decision? (Revuud)
• Unlocking the full potential of your specialty hub (RxLightning)
• Why We Built This: A Network of Innovation (Surescripts)
• A Vision for Healthcare Supply Chain: Insights from Key Industry Leaders (Symplr)
• How to Minimize Financial Impacts During Healthcare Cybersecurity Incidents (Tegria)
• Empowering Caregivers: The Connecting Caregivers to Medicare Act (Trualta)
• Beyond Process and Tech: Cultivating a Collaborative Culture for Denials Prevention (VisiQuate)

Contacts

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