Some health insurance companies are rethinking prior authorization amid a groundswell of complaints from patients and providers and intensifying government scrutiny. Health insurance companies employ prior authorization rules to constrain … Read More
Hospital tech executives are managing more digital health applications at a time when their systems face multiple threats to business continuity and patient safety. Amid greater threats to cybersecurity and … Read More
More than three-quarters of at-risk nursing homes report they are inadequately prepared for major emergencies, according to new findings from a federal watchdog. The Health and Human Services Department Office … Read More
Hospitals’ chief complaint about the 340B remedy payment proposed rule is that it is budget neutral, which the federal government likely won’t be able to change. The Centers for Medicare and … Read More
Private equity firm Thoma Bravo will acquire electronic health records vendor NextGen Healthcare for $1.8 billion, the companies announced Wednesday. The deal will bring an end to NextGen’s four decades … Read More
Gig workers are making their way into hospitals in the form of nurses picking up shifts and working alongside staff clinicians caring for patients. Their arrival comes as health systems … Read More
The Centers for Medicare and Medicaid Services will offer as many as eight states up to $12 million each to implement a new payment model designed to improve population health, … Read More
A shortage of healthcare workers nationwide could worsen once nursing homes are required to meet minimum staffing requirements set by the federal government. The Centers for Medicare and Medicaid Services issued the long-awaited … Read More
The healthcare industry is facing a wide variety of challenges—and solutions aren’t always straightforward. Each month, Modern Healthcare asks leaders in the field to weigh in on their approaches to … Read More
Pennsylvania on Tuesday became the latest state to join the nurse licensure compact, which is expected to aid Pennsylvania providers’ efforts to recruit nurses. Its addition means there are 41 … Read More
Elizabeth Amirault had never heard of a Narx Score. But she said she learned last year the tool had been used to track her medication use. During an August 2022 … Read More
Robotic companion company raises $25M from Toyota’s growth fund Intuition Robotics, a company that has developed an artificial intelligence-enabled robotic companion for seniors, raised $25 million. The funding, which includes … Read More
Dr. Ravi Thadhani, executive vice president for health affairs at Emory University and executive director of Emory’s Woodruff Health Sciences Center, joins Modern Healthcare to discuss how the academic health system … Read More
The four companies delivering care on Amazon Clinic say joining the direct-to-consumer telehealth marketplace hasn’t forced them to rewrite their business plans. Amazon Clinic, the tech giant’s direct-to-consumer telehealth marketplace, … Read More
Eighteen months ago, President Joe Biden stood before Congress during the State of the Union address and vowed that his administration would be the first to set national standards for … Read More
Humana is suing to block the implementation of a plan to recoup billions of dollars the federal government says it overpaid to Medicare Advantage carriers. The health insurance company filed … Read More
Follow here for the latest updates on artificial intelligence in healthcare. Source link
Walgreens Boots Alliance CEO Rosalind Brewer has stepped down as head of the company and as a member of its board of directors, the company said Friday. Brewer and the … Read More
The University of Pittsburgh Medical Center reported 118 days of cash on hand in its second-quarter earnings, compared with 112 days in the year-ago period. Since December, UPMC’s unrestricted cash … Read More
The Health Resources and Services Administration is awarding $80 million in federal grants to rural medical centers, universities and community organizations to help fight the opioid crisis. The funding will be … Read More
One Medical CEO Amir Dan Rubin will step down from the Amazon-owned primary care provider later this year after more than six years at its helm. The change comes less … Read More
JEFFERSON CITY, Mo. — Children in many states are being wrongly cut off from Medicaid because of a “glitch” in the automated systems being used in a massive eligibility review … Read More
RALEIGH, N.C. — With the state budget’s passage now two months late, North Carolina Gov. Roy Cooper’s administration announced Monday that it can’t start the implementation of Medicaid expansion to … Read More
The National Committee for Quality Assurance is updating its Healthcare Effectiveness Data and Information Set performance measures for health insurance companies next year with an eye toward health equity and … Read More
Across the nation, nurses are demanding a seat at the table to drive meaningful, long-overdue policy changes and improvements to their working conditions—and lawmakers and healthcare leaders are paying more … Read More
Humana’s CenterWell Senior Primary Care is joining the growing ranks of providers offering in-home care to older adults through a new program called Primary Care Anywhere. The home care initiative … Read More
AdventHealth is refocusing on its core operations. The system sold 10 skilled nursing facilities this year: one in Texas and one Kansas in March, each to CareTrust REIT, and eight … Read More
The Texas Medical Association notched another win in its legal challenges to the No Surprises Act, further complicating the law’s implementation. Judge Jeremy D. Kernodle of the U.S. District Court … Read More
The Biden administration last year promised to establish minimum staffing levels for the nation’s roughly 15,000 nursing homes. It was the centerpiece of an agenda to overhaul an industry the … Read More
WASHINGTON — The blood thinner Eliquis and popular diabetes treatments including Jardiance are among the first drugs that will be targeted for price negotiations in an effort to cut Medicare … Read More
Each year, Modern Healthcare’s Revenue Cycle Firms Survey asks companies about the state of the industry and what they predict for the future. Click here to see the full results … Read More
Providence Health & Services is still working to recover from last year’s multibillion-dollar losses. The Renton, Washington-based system on Monday reported a net loss of $232 million in the first … Read More
Bon Secours Mercy Health sued Anthem Blue Cross Blue Shield on Monday, alleging that the insurer owes the health system nearly $100 million in unpaid, reduced and denied claims for … Read More
“We don’t need to own certain elements of the care continuum that aren’t part of our core business,” said Robert Garrett, CEO of Edison, New Jersey-based Hackensack Meridian Health. “We … Read More
The Centers for Disease Control and Prevention has released guidelines to help hospitals create more effective sepsis management teams and improve patient survival rates. The agency’s seven “Sepsis Core Elements,” … Read More
Even subtracting the state and federal assistance, Corewell Health’s operating margin was nearly twice that of the first six months in 2022. The midyear 2023 financial results compare to the … Read More
Two health systems of vastly different sizes are using technology to tackle a widespread problem—clinician burnout. Burnout was already an issue for providers and the COVID-19 pandemic exacerbated the problem. A … Read More
Nursa nabs $80M Series B round Nursa, a nurse staffing platform company, completed an $80 million Series B funding round led by venture capital firm Drive Capital. Nursa’s staffing platform … Read More
Madera Community Hospital in California’s Central Valley, which ceased operations last December and filed for Chapter 11 bankruptcy in March, moved a step closer to reopening Thursday when California’s new … Read More
Hollywood, Florida-based Memorial Healthcare System began a journey just over a year ago to screen all patients for social factors that can influence health. Dr. Jennifer Goldman, a primary care … Read More
Nearly two-thirds of Medicare Shared Savings Program accountable care organizations earned shared savings last year, the Centers for Medicare and Medicaid Services announced Thursday. These ACOs saved Medicare $1.8 billion … Read More
A federal appeals court has revived a high-profile class action lawsuit that accuses a UnitedHealth Group subsidiary of improperly denying mental health claims. A three-judge panel of the U.S. Court … Read More
Nonprofit healthcare systems are adding or expanding facilities in an effort to keep up with patients’ growing demands, despite a challenging operating environment. At the University of Pittsburgh Medical Center, construction … Read More
Healthcare providers are struggling to get patients to tell them about problems they face outside of the exam room. Providers want patients to tell them about their social needs but … Read More
CVS Health-backed primary care provider Oak Street Health struck a multiyear deal with Strive Health to offer care focused on patients with chronic or end-stage kidney disease. With the partnership, … Read More
UnitedHealth Group is laying off Optum employees as it restructures its healthcare service subsidiary. The healthcare conglomerate cut jobs at MedExpress urgent care clinics and at WellMed Medical Group this … Read More
Allina Health said Wednesday it rescinded a policy that denied non-urgent treatment to patients with unpaid medical bills. The announcement follows reporting in June by The New York Times that revealed the … Read More
Epic on Tuesday unveiled a series of vendor relationship programs that will exist in an online gallery called Showroom, replacing the company’s app market that shut down in December. As part … Read More
Cyberattacks can have far-reaching impacts on healthcare organizations, leading to costly disruptions in operations and regulatory hurdles to address. Cybersecurity and risk management experts say healthcare organizations can mitigate those consequences … Read More
The political fight over states clearing their Medicaid rolls has reached a federal courtroom after an advocacy organization sued Florida Tuesday. According to the most recent data, Florida removed 408,000 … Read More
LOS ANGELES — A succession of power outages at a Los Angeles hospital prompted the evacuation of 28 patients in critical condition to other hospitals early Tuesday, while 213 other … Read More
2. Employers are split on GLP-1s for weight loss. The rising popularity of weight-loss medications has raised questions for employers on whether to cover the pricey drugs. Glucagon-like peptide agnostics, … Read More
The issue Overwhelmed with the ongoing migrant crisis, New York City declared a state of emergency and made the eyebrow-raising move of awarding a $432 million, no-bid contract to a … Read More
Minnesota authorities are investigating Allina Health over reports that the nonprofit provider refused to treat some patients who owed medical debts, state Attorney General Keith Ellison (D) announced Friday. The … Read More
The circumstances and reason for Schwartz’s departure are unclear. System representatives declined to comment beyond a press release. “This was a mutual decision,” Schwartz said in the release. “I am … Read More
The healthcare industry has a lot to grapple with, from financial challenges and workforce shortages to a pivotal 2024 election and disruptive, innovative care models that present both challenges and … Read More
As the Centers for Medicare and Medicare Services weighs the future for hospital-at-home services under Medicare, providers are pressing more states to extend it to Medicaid beneficiaries. Eight states—Arizona, Arkansas, Massachusetts, … Read More
Blue Shield of California expects to save $500 million a year on prescription drugs by spreading its pharmacy benefit management operations among five companies and significantly scaling back its relationship … Read More
The collaborative environment has allowed the VA to experiment on several initiatives, including a medical virtual reality simulation lab project with Nemours, said Dr. Graig Blevins, VA Orlando’s chief of … Read More
Shah, Agarwal and Purdy — who face up to 30 years each when they’re sentenced in October and November — have asked U.S. District Judge Thomas Durkin to overturn their … Read More
Mayo Clinic is the latest nonprofit health system seeing the benefits of improved patient volumes. The Rochester, Minnesota-based system saw a 10.4% year-over-year jump in patient service revenue, to $3.54 … Read More
Viome announces $86.5M round, CVS roll out Viome Life Sciences, a startup diagnostics company, closed an $86.5 million Series C funding round Friday. Viome has developed multiple diagnostic tests for gut … Read More
Follow here for the latest updates on mergers, acquisitions and partnerships in healthcare. Source link
Oregon has become the fourth state to enact a law requiring nurse-to-patient ratios at hospitals, a move praised by labor groups and panned by health systems. Hospitals in the state will … Read More
JEFFERSON CITY, Mo. — As millions of Medicaid recipients face the potential loss of health coverage for the first time since the coronavirus pandemic, state call centers are getting inundated … Read More
Visana Health, a virtual women’s health clinic, announced the close of a $10.1 million seed funding round co-led by Flare Capital Partners and Frist Cressey Ventures. The company plans to … Read More
NEW ORLEANS — New restrictions on access to a drug used in the most common form of abortion in the U.S. would be imposed under a federal appeals court ruling issued … Read More
An Oklahoma law aiming to regulate pharmacy benefit managers’ retail networks and pharmacist contracts is unconstitutional, the U.S. Court of Appeals for the 10th Circuit ruled. The three-judge panel on … Read More
Recruiting and retaining talent remains one of the top challenges for healthcare organizations as labor costs rise and patient demand soars. A growing and aging population, post-COVID-19 physician burnout and … Read More
The national system for allocating and distributing human organs for transplantation is on the verge of a transformation that advocates have sought for years. After an outcry from providers and … Read More
Epic is going to allow select third-party vendors to work more closely in its electronic health record platform, and one of the first participants is calling it a “stamp of … Read More
Private equity deals in healthcare services fell nearly 24% during the second quarter, to the lowest point since 2020, according to PitchBook’s latest Healthcare Services Report. The report estimated 164 … Read More
Attendees gathered in downtown Chicago Aug. 9-11 to hear stories and advice from prominent women in the healthcare industry as part of Modern Healthcare’s annual Women Leaders in Healthcare Conference. … Read More
Specialty care is joining primary care and urgent care in the transition from brick-and-mortar facilities to the home. On Tuesday, in-home care provider MedArrive said it will begin offering on-demand … Read More
“How much is the ice cream?” A simple enough question, featured on a new TV and online advertisement, posed by a man who just wants something cold. A woman behind … Read More
The Centers for Medicare and Medicaid Services debuted a slate of changes to ACO REACH on Monday that are designed to boost participation in the value-based care program. The agency’s … Read More
Publicly traded digital health companies facing a challenging economic environment have responded with diverging paths. As quarterly earnings have been reported in the past few weeks, it’s clear some digital health … Read More
The Inflation Reduction Act of 2022 provides billions of dollars in direct funding and tax incentive opportunities that health systems can use to finance climate resiliency and renewable energy infrastructure … Read More
The Health and Human Services Department’s Health Resources and Services Administration will distribute $100 million to select universities and health systems to help expand the nursing pipeline with more faculty … Read More
NASHVILLE, Tenn. — Vanderbilt University Medical Center is facing a federal civil rights investigation after turning the medical records of transgender patients over to Tennessee’s attorney general, hospital officials have … Read More
Hospitals across the country have been grappling with employee and leader burnout, with a significant number of clinicians rethinking their careers and CEOs exiting. Workplace pressures have been amplified by … Read More
Easing capacity constraints is a key focus for Mass General Brigham as it works to trim operating costs through better use of its resources. The Boston-based nonprofit system said Friday … Read More
Elon Musk’s Neuralink lands $280M from Peter Thiel’s VC Neuralink, a neurotechnology company founded by Elon Musk, raised $280 million in a Series D funding round. The round was led … Read More
Health systems are extending their recruitment reach as they look to continue to decrease the use of staffing agencies and mitigate persistent shortages. Workforce constraints were a central theme of … Read More
Home health provider Enhabit is considering a potential sale, merger or strategic transaction in another sign that continued financial headwinds are likely to force further consolidation in the sector. The Dallas-based … Read More
Membership-based primary care provider Cano Health is laying off 700 employees, exiting four markets and exploring a sale, the company said Thursday. The plans were disclosed as the company reported … Read More
Worsening violence in healthcare settings presents providers with a vexing dilemma: How to maintain safety and security for staff and patients without creating unwelcoming, closed environments in what are meant … Read More
Kaiser Permanente will receive the biggest per-member bonus from the Medicare Advantage star ratings program in 2023, an analysis found. The Centers for Medicare and Medicaid Services will pay the … Read More
Here we go again: COVID-19 hospital admissions have inched upward in the United States since early July in a small-scale echo of the three previous summers. With an updated vaccine … Read More
The healthcare industry is facing a wide variety of challenges—and solutions aren’t always straightforward. Each month, Modern Healthcare asks leaders in the field to weigh in on their approaches to … Read More
Bright Health reduced its revenue guidance for the year as the soon-to-be former health insurer advances the sale of its final insurance asset, the company reported Wednesday. The company downgraded … Read More
The Centers for Medicare and Medicaid Services is revising its patient experience survey to address low response rates and expand data on care quality. Announced Aug.1 as part of the … Read More
Earlier this year, Sen. Jeanne Shaheen (D-N.H.) introduced the Prescription for Digital Therapeutics Act, which would provide for Medicare and Medicaid coverage of prescription digital therapeutics and establish a payment … Read More
Oscar Health plans to extend its geographic reach and launch new products next year to counter shrinking membership, CEO Mark Bertolini said Tuesday. Enrollment fell 6.4% to 970,543 during the … Read More
Medical coworking is gaining traction among physicians who want to stay independent in a rapidly consolidating industry. Coworking companies that manage the spaces often provide front-desk staff and standard exam … Read More
It’s early days for health system leaders interested in implementing generative artificial intelligence, according to a report published Monday from consultancy Bain & Company. For the report, Bain surveyed 94 health system leaders, … Read More
Babylon Health said Monday its proposed deal to go private with MindMaze, a digital health company focused on brain health, will not move forward. Babylon, an artificial intelligence-enabled virtual diagnosis … Read More
Nautic Partners has agreed to acquire Tabula Rasa HealthCare in a take-private deal, the pharmacy benefit manager announced in a news release Monday. The private equity firm plans to merge … Read More
Bright Health Group has secured a $60 million credit agreement that enables the struggling startup to survive while it completes a sale of its final insurance operation to Molina Healthcare, … Read More
Mass General Brigham sees hospital-at-home care as a big part of its long-term future. In the short term, the nonprofit health system’s plan depends on a favorable ruling from the … Read More
