Top News
A ransomware group claims that its cyberattack against Change Healthcare yielded 8 terabytes of data from every provider that sends data to Change, including medical records, insurance records, and data from active military service members. The group quickly removed its post, raising speculation that the company might be negotiating a ransom payment.
CommonWell uses Change technology and has disabled its network as a precaution.
Meanwhile, the American Hospital Association asks HHS for help with the Change Healthcare attack, requesting better communication and transparency from Change, help with payments that will be delayed, pausing of citations related to wait times, enforcement discretion for the lack of ability to create good faith estimates, and added flexibility in e-prescribing regulations.
MGMA lists the problems its medical group members are experiencing due to the Change Healthcare disruption:
- Claims cannot be submitted.
- Prior authorization requests cannot be submitted.
- Patient eligibility can’t be checked.
- Health plan payments cannot be received.
- Prescriptions and lab orders cannot be transmitted electronically.
- Medical groups don’t carry reserves year-over-year due to tax consequences, so they are running short on working capital due to their inability to bill and be paid.
Reader Comments
From EHRMusing: “Re: Epic. I’m interested in your thoughts on this article that examines whether it’s a monopoly.” The Forbes article – which was pretty good except for spelling Judy Faulkner’s name wrong – makes these points:
- Epic holds a 36% market share of US hospitals, short of the usual monopoly definition of 50%.
- The company’s aggressive IP protections, such as non-competes and controlling who can work on a client’s Epic team, could be construed as monopolistic behavior.
- Epic increases third-party costs by limiting developer access, and controls access to its ecosystem via its new Showroom third-party marketplace.
- The nature of buying Epic gives more influence to health system CIOs and thus Epic.
- Epic pre-empts competition by announcing products before their release and by publishing a “Products You Can Replace With Epic” guide.
- Epic plays a positive role in filtering “innovation noise” from flaky startups, gives health systems a single point of contact, and has been around for 45 years with no involvement by outside investors.
- The article didn’t mention other important monopoly factors – a high barrier to entry, the ability to set prices above competitive levels, and lack of substitutes, all of which apply to Epic.
- My opinion is that the IP concerns are valid, but otherwise Epic grew because if offers a better product for the academic health systems where it enjoys a high market share. Monopolistic behavior requires intention, and I don’t think Epic intentionally stifles competition in unsavory ways. The market voluntarily accepted its offerings as superior, and if CIOs preferred Epic because of the cool factor and future job prospects, that’s not Epic’s fault.
- Most amazing to me is that the fresh-from-college kids that Epic sends to prestigious health systems earn the full attention of C-level executives who buy into Epic’s way of running health systems, which is either a tribute to Epic or a criticism of those highly paid executives who let a software vendor tell them how to run their business.
From HisTalk2Fan: “Re: Teladoc results. Any comments? Do you think the company will survive long term?” My thoughts:
- TDOC shares are down 46% since the company’s IPO in mid-2015, and even worse, are down 95% over the past three years. Share price dropped 25% on the most recent earnings report, with the company blaming macroeconomic conditions rather than its own missteps. Shares in competitor Amwell have tanked equally dramatically, suggesting that the problem is that virtual visit demand didn’t stick once the pandemic eased.
- The company has reported just one profitable quarter in 32 earnings reports.
- Everybody knows that the company wildly overpaid for Livongo in October 2020, as experienced investor Glen Tullman hypnotized Teladoc CEO Jason Gorevic – who had no CEO experience prior to Teladoc – into buying Livongo for a staggering $18.5 billion, stoking Gorevic’s ambition to become a mini-Glen level industry player in a swing (and a miss) for the fences. Teladoc announced vague plans to spend the proceeds of temporarily popular COVID virtual visits to expand beyond telehealth, which based on dramatically falling telehealth demand, might have been the right idea, but certainly the wrong execution.
- Gorevic somehow kept his job and at least provided the overhyped healthcare startup market with a cautionary tale about irrational exuberance. Teladoc filed a $13.7 billion loss from the acquisition just two years later, and the company’s bragging about its $37 billion value has quieted down now that the whole package is worth just $2.5 billion.
- Meanwhile, last week’s earnings report showed a 46% fall in telehealth visits as Gorevic warned of a well-penetrated market and low single-digit growth for US virtual care products. He also announced plans to expand into weight management and pediatrics while characterizing its virtual care business as a “very stable asset” despite obvious evidence to the contrary.
- BetterHelp, which was about the only good news for the company in previous quarters, failed to meet expectations for revenue and margins.
- I assume the company will survive in some form, but its heyday – if it ever had one – is long past, and they are left with rounds of cost-cutting and trying to shoo away the circling vultures.
From Nomenclaturist: “Re: health system mergers. Why do you usually call them acquisitions?” A merger implies that two companies will combine to do business as a newly formed company, which is rarely the case with health systems. If Health System A and Health System B announce that they will merge and will operate under the Health System A name, then I assume that Health System A is the acquirer and the “merger of equals” characterization is to avoid making the acquired system feel inferior (which they obviously are or they wouldn’t be selling out). I also look to see which company provides the CEO and if one of the health systems will assume the liabilities of the other.
HIStalk Announcements and Requests
I’ve been away and mostly offline for several days, and the fact that you didn’t notice is a tribute to Jenn, who happily follows my doggedly exacting but sometimes quirky writing rules so that the “product” does not vary in my absence. It was fun to enjoy HIStalk as a reader and to find nothing to second guess about the news items she chose or the way she worded them. In fact, Jenn could probably have outdone me today since I’m recovering from a bug.
This is the final call for sponsors to tell me about their HIMSS24 plans for my guide.
Some folks seem surprised that Billy Idol was good at ViVE. Not me, since I saw him years ago when House of Blues Las Vegas comped me a ticket to his show when I was scouting for HIStalkapalooza there. I figured that the spiky, sneering, nearly septuagenarian Billy hadn’t made waves in 40 years and even then in the now-defunct genre of angry Brit punk, but he put on a good show to a self-selected audience who prefer listening to music from their college-aged years.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
Acquisitions, Funding, Business, and Stock
The Washington Post says that since Amazon’s acquisition of One Medical — the parent company of Medicare-focused Iora Health, which operates in nine metro areas – the business now known as One Medical Seniors has shortened appointments, laid off clinicians, pushed virtual visits to reduce in-person ones, and eliminated much of Iora’s legendary personal interaction and care coordination, all under the usual corporate excuse-making as necessary to “position One Medical for long-term, sustainable success.” The report also notes that Amazon will be challenged to scale One Medical by offering Prime members a discount because of the its limited geographic coverage. The company has implemented a call center and AI chatbot triage to manage an increased number of telehealth visits. Business Insider reported a couple of weeks ago that Amazon has talked about spinning off the former Iora Health business to reduce One Medical’s projected loss of $342 million this year.
Columbus-based Redi Health, which offers digital pharma support to patients with chronic conditions, raises $14 million in Series B funding. Co-founder and CEO Luke Buchanan came from CoverMyMeds.
Healthcare interoperability vendor Moxe Health receives $25 million in growth capital. CEO Dan Wilson founded the company in 2012 after several years at Epic.
Northwell Health announces plans to acquire Nuvance Health, which would create a 28-hospital system with $18 billion in annual revenue.
The federal government launches an antitrust investigation into UnitedHealth Group, with an apparent focus on the relationship between its insurance business and the healthcare services business of its subsidiary Optum, which is the largest employer of physicians in the US. The justice department previously challenged the company’s $13 billion acquisition of Change Healthcare in 2022, but lost. Change Healthcare’s ransomware attack that has brought US healthcare to its knees is making a good case for the feds.
Online vanity drug prescribing company Hims & Hers Health reports Q4 results: revenue up 65%, EPS $0.01 versus –$0.05, becoming on of the first digital health companies (if that’s what you call it) to show a profit. The company says that new services for weight loss, mental health, and dermatology could each deliver $100 million in revenue starting next year. The company seems excited about the launch of its compounded Hard Mints chewable version of erectile dysfunction drugs.
People
Rhapsody hires Jitin Asnaani, MBA (Health Gorilla) as chief product officer.
Beth Gall (Mantra Health) joins Rainfall Health as VP of sales.
Mark Gee (WellSky) joins Medecision as chief revenue officer.
Former Estes Park Health (CO) CIO Gary Hall, who retired in September 2023, is running for town mayor.
Announcements and Implementations
The Sequoia Project and HL7 will collaborate to accelerate the adoption of FHIR standards in the US. Their initial focus will be on:
- Scalable registration, authorization, and authentication.
- Interoperable digital identity and patient matching.
- Hybrid / intermediary exchange.
- Consent at scale.
Highmark Health will use Epic’s Payer Platform running on Google Cloud to glean insights that can be used to inform consumers of the next best actions. The company says that more than half of its 7 million members are attributed to an Epic-using provider, allowing it to close care gaps automatically.
Several health systems and vendors begin beta testing Hippocratic AI’s healthcare-built LLM, with priority areas being chronic care management, post-discharge follow-up, social determinants of health surveys, health risk assessments, and pre-operative outreach. I was amused to see that the company’s dozen unlabeled photos of healthcare professionals are almost certainly generated by AI in the “dogfooding” style, as verified by Is It AI that places the AI-generated odds at 99.27%.
Keysight announces an AI/ML network validation and optimization solution.
Elsevier Health launches ClinicalKey AI, which provides clinicians with a personalized conversational search interface for medical literature that incorporates patient context and provides linked citations.
A study finds that 58% of the NeuroFlow users who were flagged via NLP as as having possible suicidal ideation would not have been identified otherwise.
A new KLAS report on home health technology finds that Homecare Homebase has a wide lead in market share, but Netsmart, WellSky, and ResMed have good market share among mostly smaller clients. Most often considered are Homecare Homebase, MatrixCare, and Epic.
Privacy and Security
The White House issues an executive order to protect the sensitive personal data of Americans – including personal health and genomic data — from “exploitation by countries of concern.” It focuses on commercial data brokers that can sell information to other countries, potentially raising privacy, counterintelligence, and blackmail concerns.
Other
The American Prospect describes what happened when Steward Health acquired Rockledge Regional Medical Center (FL):
- The CEO of Wuesthoff Health System, the two-hospital nonprofit that owned Rockledge, sold out to Health Management Associates, which earned his C-suite a $10.6 million golden parachute, after which the hospital was then sold to Community Health Systems and then sold again to Steward, who used money from the medical properties trust that bought Steward’s real estate.
- Steward immediately sold the hospital’s hospice center and home health business and outsourced entire departments.
- Nurses report that the hospital runs short of medical supplies and has had medical equipment repossessed. The hospital has been sued by dozens of vendors for non-payment.
- Five of the hospital’s nine elevators have been out of service for a year.
- The company balked at paying exterminators $1 million to remove 5,000 bats from the facility whose guano backed up hospital sinks and pipes.
- Steward stopped showing up at legal proceedings after the Boston paper noted that the company was $1.4 billion in the red when founder and CEO Ralph de la Torre bought himself a $40 million yacht and the Globe exposed the flight records of the company-owned jet that showed trips to Corfu, Santorini, and Antigua.
- Despite all of its problems, the hospital passed its Joint Commission survey and earned an A grade from the Leapfrog Group. Former employees said that the only thing Steward is good at is hiding problems from inspectors.
- Negative company news hasn’t been run in Florida, leading some to predict that the chain is trying to morph into a Florida-only system as state legislators look the other way and lean on news outlets to do the same.
Sponsor Updates
- Censinet publishes its “2024 Healthcare Cybersecurity Benchmarking Study.”
- Lucem Health incorporates Ryght’s generative AI capabilities into its AI SolutionOps platform.
- Arcadia releases its next-generation data platform powered by an open lakehouse architecture.
- Odessa General Surgery Robotics (TX) adds Sunoh.ai medical AI scribe capabilities to its EClinicalWorks EHR.
- Symplr releases the results of its “State of Healthcare Supply Chain Survey.”
- HealthMark Group adds Credo Health’s PreDx record retrieval technology to its Request Manager medical records software.
- AvaSure selects Oracle Cloud to power its AI-enabled virtual care platform.
- Black Book Research’s latest analysis recognizes Netsmart as the top-performing provider in geriatric medicine EHR and practice management software.
- Net Health publishes findings from a new study, “What’s Delaying Advanced Analytics Adoption in Healthcare?”
- FinThrive releases a new episode of its Healthcare Rethink Podcast, “Take a Deep Breath … Virtual Healthcare is Here!”
- Healthcare IT Leaders CEO Ben Hilmes will chair the Kansas City Light the Night Corporate Walk in support of the Leukemia & Lymphoma Society.
- Inovalon will exhibit at Rise National March 17-19 in Nashville.
- Konza National Network publishes its 2023 Annual Impact Report.
- Medhost releases a new customer testimonial featuring Freestone Medical Center in Texas.
- Meditech announces that the Rotherham Hospital is at the forefront of patient data-sharing with the integration of GP Connect.
- MRO will exhibit at the Minnesota HFMA’s HLAMN Winter Conference March 5-6 in St. Paul.
Blog Posts
Contacts
Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.
Oracle doesn't need FDA approval. Most EHRs are excluded from the definition of a medical device by the 21st Century…