Healthcare and Insurance News Headline Updated on 28 Feb 2020

The headline on 28 Feb 2020

Lawmakers say Cigna and Optum aren’t cooperating with a probe looking at the pricing of insulin — and threatened a subpoena. Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., are pushing Express Scripts and Optum on the lack of information they’ve provided for the senators’ probe into insulin prices. Source: 2020-02-25 CEG RW to Cigna (Failure to Produce).pdf

A new study shows that people enrolled in short-term health plans can face high out-of-pocket costs for cancer care. Source: The impact of short-term limited-duration policy expansion on patients and the ACA individual market

The CDC is rolling out a new ICD-10 code for the coronavirus. Hopefully, not many healthcare organizations will need to use it, but there’s now an ICD-10 code for treating patients with coronavirus. Source: New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), October 1, 2020

The headline on 27 Feb 2020

While Medicaid expansion successfully reduced nonprofit hospital spending on uncompensated care, that doesn’t mean they’re spending more on charity care. Source: JAMA Network > Association of Nonprofit Hospitals’ Charitable Activities With Unreimbursed Medicaid Care After Medicaid Expansion

Blue Shield of California has unveiled a new tech collaboration aimed at making it easier for large employers to engage members around their benefits. Here’s how it works. Source: Blue Shield of California and Accolade to Provide Personalized Healthcare Solutions for Self-Funded Employers

During an earnings call Wednesday, Teladoc officials told analysts they are working with U.S. officials and hospitals to prepare for an uptick in the use of their telehealth tech in response to the potential spread of coronavirus in the U.S.. Though the spread of coronavirus has hit the stock market, Teladoc execs are watching closely in case the outbreak could boost the need for telehealth. Source: Teladoc Health Reports Fourth-Quarter and Full-Year 2019 Results

Doctors know patients aren’t always truthful. But what are the things they lie to their doctors about? Source: TermLife2Go > WE ASKED 500 PEOPLE, “DO YOU LIE TO YOUR DOCTOR?”

The headline on 26 Feb 2020

Aetna announced it will expand its Whole Health plans into the Atlanta market. Here’s a look at the health systems teaming up on that effort. Source: CVSHealth > Aetna Whole Health Launches In Atlanta Providing Fully Insured And Self-Insured Health Care Options For Employers

When KLAS Research asked more than 300 healthcare leaders to identify the most disruptive company in healthcare, one tech giant was top of mind. But they found plenty of smaller, emerging companies getting a lot of buzz as well. Source: Amazon Care

Tech giant Apple is pushing deeper into health research with a new virtual heart study in collaboration with Johnson & Johnson. Source: Heartline

U.K.-based Babylon Health is embroiled in a feud with a doctor who raised safety concerns about its AI chatbot. The startup issued a press release calling the doctor a “Twitter troll” while also defending the accuracy of its AI. Source: AINEWS > Babylon Health lashes out at doctor who raised AI chatbot safety concerns

The headline on 25 Feb 2020

Blue Cross Blue Shield of Michigan has added seven new providers to its new Blueprint for Affordability model, taking the value-based care program statewide. Find out more on what that looks like. Source: MI Blues Perspectives > Blue Cross Blue Shield of Michigan extends transformative payment model to communities across the state

It’s not just the Democratic presidential contenders who are bickering over healthcare. California’s state legislators are, too, as Kaiser Health News reports. Source: KHN > Congressional Candidates Go Head-To-Head On Health Care — Again

Labs in the U.S. plan to start monitoring the general population for the coronavirus this week, CDC officials said. Source: The Verge > Labs in the US will start looking for the new coronavirus this week

UnitedHealthcare is dropping hundreds of physicians from its New Jersey Medicaid network, separating patients from longtime doctors. Physicians charge the insurer is using its market power to shift business to practices it controls, Kaiser Health News reports. Source: KHN > Needy Patients ‘Caught In The Middle’ As Insurance Titan Drops Doctors

Surgery is the second most common cause for medical malpractice claims against doctors, according to a new analysis Is it time operating rooms consider adopting the so-called “sterile cockpit” concept used in aviation to reduce distractions? Source: Coverys > A Dose of Insight – Surgery Risks: Through the Lens of Liability Claims

Federal regulators say they have listened to physicians’ complaints about health IT burdens and they have a strategy for some solutions. Source: HealthIT.gov > Strategy on Reducing Burden Relating to the Use of Health IT and EHRs

The headline on 24 Feb 2020

A non-profit is betting on a “moonshot factory” to help developing nations. Here’s how it wants to bring cutting-edge healthcare technologies to remote villages in Uganda and Nepal. Source: Medic Mobile > Introducing the Community Health Toolkit

NRC Health — which administers patient survey tools to 75% of the 200 largest U.S. hospital chains — is recovering from a ransomware attack that hit last week. Source: CNBC > Cyberattack on NRC Health sparks privacy concerns about private patient records stored by US hospitals

Physician company Mednax revealed that UnitedHealthcare has booted it from networks in four states. That could have implications for surprise medical billing. Source: MEDNAX Reports Fourth Quarter Results

The headline on 21 Feb 2020

The University of California, Irvine, will start construction this month on a new nine-acre integrative medicine campus including landscape design elements to support activities such as yoga and tai chi, a Zen garden, and a 600-foot-long wellness walk that leads to the School of Medicine’s Biomedical Research Center. Source: UCI News > UCI to start construction on Samueli College of Health Sciences complex

The U.S. Indian Health Service is refusing to release a report about one of its pediatricians who was convicted of sexually abusing children on two reservations, the Wall Street Journal reports. Source: The Wall Street Journal > Indian Health Service Declines to Release Report on Sexual Abuse

UnitedHealthcare is warning that dental care can play a critical role in the opioid epidemic, especially for adolescents. Here’s what they’re doing about it. Source: UnitedHealthcare > The Opioid Epidemic and Its Connection to Dental Care

The headline on 20 Feb 2020

Data from NORC reveals that 8 million Americans have created a crowd-funding campaign for themselves or someone in their household to cover medical bills. Plus, 12 million have created one for someone else. Source: NORC > Millions of Americans Donate through Crowdfunding Sites to Help Others Pay for Medical Bills

Health system giants — including CommonSpirit,Community Health Systems and Ascension — reported their earnings this week. Source: CommonSpirit Health Consolidated Financial Statements

Healthcare data breaches soared last year, nearly tripling to 41 million patient records affected, according to a report that offers insight into the top cyberthreat trends. Source: Protenus Industry Reports

This is painful. The Mayo Clinic’s medical school emailed 364 students acceptance letters. It was a mistake.

The headline on 19 Feb 2020

The number of rural hospitals that shut their doors reached a record-setting 19 last year, according to a new report that aims to pinpoint why hospitals are closing. Source: The Rural Health Safety Net Under Pressure: Rural Hospital Vulnerability

Express Scripts released its annual Drug Trend Report. Take a look at the drugs they say are driving up spending. Express Scripts released its annual look at drug spending trends, and in the report it highlights the drug classes that are behind increased spending. Source: Express Scripts > 2019 Drug Trend Report

A new survey shows that surprise medical bills are a major concern for Medicare beneficiaries. Robert King has more on what else they’re afraid of. Source: Nearly Two Thirds of Medicare Enrollees Worry about Surprise Medical Bills, According to eHealth Survey

Experts warn that the spread of coronavirus could have an impact on first-quarter earnings for a variety of businesses, CNN reports. Source: CNN Business > Apple’s coronavirus warning was a foreshock for earnings. But investors shouldn’t freak out just yet

Executives are bullish on the potential of artificial intelligence to improve healthcare. But they say adoption is not happening quickly enough for several big reasons. Source: KPMG > Living in an AI World

China is turning to health-rating apps from tech giants Alibaba and Tencent to help classify people based on the health conditions and travel history, adding a new and controversial tool in the country’s battle to contain the coronavirus outbreak. Source: The Wall Street Journal > China Turns to Health-Rating Apps to Control Movements During Coronavirus Outbreak

The headline on 18 Feb 2020

The Nevada caucuses are the next step in the ongoing Democratic primary. Here’s what you need to know from USA Today. Source: What you need to know about the Nevada Democratic caucuses

Humana CEO Bruce Broussard discussed the insurer’s new primary care venture at a conference last week. Tina Reed has more on what he had to say about how company officials think when it comes to building up the healthcare — rather than the insurance — side of their business.

Will surprise billing solutions be more provider- or payer-friendly? Robert King dove into three possible paths under consideration in Congress.

The Nevada caucuses are the next step in the ongoing Democratic primary. Here’s what you need to know from USA Today.

Hospitals that are financially better off spend proportionally less — way less — than their peers on charity care, according to a research letter in JAMA Internal Medicine. Take a look at their numbers. Source: JAMA Network > Charity Care Provision by US Nonprofit Hospitals

A new study in JAMA finds private equity firms are buying up more physician practices. Find out which specialties generated the most interest. Source: JAMA Network > Private Equity Acquisitions of Physician Medical Groups Across Specialties, 2013-2016

A Georgia doctor is going to prison for 20 years after being found guilty of dispensing controlled substances, sometimes in exchange for cash or sex. Source: DoJ > Pill-mill doctor gets decades in prison for healthcare fraud, illegally dispensing massive amounts of drugs

The headline on 14 Feb 2020

In Florida, Walgreens and CVS filed a third-party complaint that says that 500 anonymous physicians are responsible for fueling the opioid crisis — not the pharmacies that filled the prescriptions for the pain drugs. Source: Ohio Court > In Re: National Prescription Opiate Litigation

As politicians in Washington look at how to address the problem of surprise bills, researchers examined claims data from a large health insurer to examine how often patients unexpectedly received out-of-network bills after having in-network elective surgery. Source: JAMA Network > Out-of-Network Bills for Privately Insured Patients Undergoing Elective Surgery With In-Network Primary Surgeons and Facilities

Researchers at Florida International University (FIU) compared compensation packages before and after the 2008 financial collapse for executives in different sectors of insurance—including health plans. There were some big changes. Source: Biz.News.flu.edu > Insurance industry CEO pay tied more closely to firm performance following the financial crisis.

The Health Care Cost Institute released its annual look at costs and utilization in employer-sponsored plans, and found price growth is starting to slow. Source: HCCI > Health Care Cost and Utilization Report (HCCUR)

Research from the CDC found that 14% of Americans struggle to pay their medical bills. Robert King has more from the study. Source: NCHF Data Brief > Problems Paying Medical Bills, 2018

A survey of U.S. physicians finds they aren’t confident about the country’s preparedness to cope with the novel coronavirus. See what else they are saying. Docs don’t feel the U.S. is prepared to contain a large coronavirus outbreak, Joanne Finnegan reports. Source: InCrowd > US Physicians Aren’t Confident About US Coronavirus Preparedness, According to InCrowd Data

The headline on 13 Feb 2020

CMS proposed a slew of changes in Part D and Medicare Advantage in a rule last week, and experts say the regs could offer new negotiation tools for Part D plans. Robert King has more. Source: Annual Advance Notice governing Medicare Advantage (MA) and Part D plans

The recession led insurance companies to rethink their approach to how they pay executives. A new study digs into how—and why. Source: BizNews.fiu.edu > Insurance industry CEO pay tied more closely to firm performance following the financial crisis.

The headline on 12 Feb 2020

CVS’ reported big jumps in its earnings and revenue last year. Here’s more on what CEO Larry Merlo had to say about the company’s turnabout. CVS Health pulled a 180 on profit last year, bouncing back from losses in 2018. We dig further into their financial results. CVS bounced back in 2019, reporting on Wednesday healthy earnings for the fourth quarter and the year after posting losses a year prior. Paige Minemyer has more. Source: CVS Health > CVS Health Reports Fourth Quarter and Full-Year 2019 Results, Reflecting Strong Execution Across the Enterprise

National Coordinator for Health IT Donald Rucker pushed back on industry opposition to an upcoming data-sharing rule. He said lawsuits against patients to collect unpaid bills prove that hospitals don’t care about privacy. Source: CNBC > Epic and about 60 hospital chains come out against rules that would make it easier to share medical info

Technology startups are jumping into the social determinants of health space. Read more about how these companies are coming up with innovative solutions to address patients’ social needs. Source: Academy Health > Health Datapalooza

The headline on 11 Feb 2020

A new study in JAMA puts a number on just how many patients receive surprise medical bills after elective surgery. See how painful the average bill is. Source: JAMA Network > Out-of-Network Bills for Privately Insured Patients Undergoing Elective Surgery With In-Network Primary Surgeons and Facilities

Physical therapists are supposed to take a major cut to Medicare reimbursements in 2021 under the physician fee schedule. They hope to convince CMS officials to reconsider.

An Alabama hospital is the latest health system identified in the U.S. to have a track record of suing hundreds of its own patients — including some that owed just $150, AL.com reports. Source: This Alabama hospital sued more than 1,000 patients last year. Some owed just $150

Anthem has several pilots using blockchain technology in the works. Heather Landi takes a deep dive into their plans. Source: Anthem Will Use Blockchain To Secure Medical Data For Its 40 Million Members In Three Years

The Trump administration finalized a survey of hospitals to acquire the payment rates for drugs purchased under the 340B discount program, much to the dismay of the hospital industry. Source: Notice from The Centers for Medicare & Medicaid Services

Consumer DNA testing companies 23andMe and Ancestry have laid off employees amid a sales slump. CNBC’s Chrissy Farr looks at how the companies can survive. Source: CNBC > Consumer DNA testing is a bust: Here’s how companies like Ancestry and 23andMe can survive

There’s been an uptick in interest by hospitals on addressing issues like food or housing among their patients. A new study took a look at just how much spending health systems are actually putting in to address those social factors. Source: Health Affairs > Quantifying Health Systems’ Investment In Social Determinants Of Health, By Sector, 2017–19

NYC Health + Hospitals is teaming up with a startup to use an e-prescribing platform to tackle food and housing insecurities among millions of patients. With the help of a grant from the Center for Medicare and Medicaid Innovation, University of Chicago physician Stacy Lindau developed a technology tool to link patients to community services. It was the seed that led to the startup NowPow, which has commercialized the e-prescribing tool she developed and most recently built a partnership with NYC Health + Hospitals. Source: NYC Health + Hospitals > OneCity Health Awards Community Partners $4.3M to Address Food and Housing Insecurities Among NYC Health + Hospitals’ Patients

The headline on 07 Feb 2020

As competition from digital rivals continues to grow, CVS and Walgreens are fast expanding their strategies to win healthcare customers. A new report examines how. Source: Coresight Research > US Drugstores Adapt to a Digital Age within Healthcare and Beauty

The number of nurse practitioners in the U.S. more than doubled in just seven years and that’s creating a problem for hospitals, according to a new study. Source: Health Affairs > Implications Of The Rapid Growth Of The Nurse Practitioner Workforce In The US

Anthem has several pilots using blockchain technology in the works. Heather Landi takes a deep dive into their plans. Source: Forbes > Anthem Will Use Blockchain To Secure Medical Data For Its 40 Million Members In Three Years

Anthony Fauci, M.D., has some simple advice for clinicians faced with a patient with respiratory symptoms and a fever—the signs of coronavirus. Joanne Finnegan has more on the one question NIH’s Anthony Fauci, M.D., says docs should be asking patients about coronavirus. Source: JAMA Network > The 2019 Novel Coronavirus (2019-nCoV)

The headline on 06 Feb 2020

The number of nurse practitioners in the U.S. more than doubled in just seven years — and that’s creating a big problem for hospitals. Joanne Finnegan has more. Source: Health Affairs > Implications Of The Rapid Growth Of The Nurse Practitioner Workforce In The US

Cigna’s profits nearly doubled last year, hitting $5.1 billion, and you can probably guess what’s behind it. (Hint: It’s Express Scripts). Source: Express Scripts and Prime Therapeutics Collaborate to Deliver More Affordable Care to More Than 100 Million Americans

The Bipartisan Policy Center wants to chart a conciliatory path forward for health reform. Robert King picks out the parts of their plan you’ll hate. Source: Bipartisan Rx for America’s Health Care

The NIAID’s Anthony Fauci offers advice to physicians faced with a patient worried about exposure to coronavirus. Source: The 2019 Novel Coronavirus (2019-nCoV)

Some horrifying new details emerge at the trial of four Detroit-area physicians found guilty of healthcare fraud. Source: DoJ > Four Detroit-Area Physicians Found Guilty of Health Care Fraud Charges for Role in Over $150 Million Health Care Fraud Scheme

More doctors are using digital health tools, according to an AMA survey. Find out which are most popular. Source: American Medical Association > Digital health tools gain momentum among physicians

The headline on 05 Feb 2020

Check out health IT funding deals in January, including Virta Health landing a $93 million in Series C funding and Komodo Health closing a $50 million funding round, led by Andreessen Horowitz.

A study in the latest issue of Health Affairs found that nearly half of antibiotics dispensed to Medicaid recipients are missed by existing US antibiotic stewardship policies. Source: Health Affairs > Non-Infection-Related And Non-Visit-Based Antibiotic Prescribing Is Common Among Medicaid Patients

Humana released its fourth-quarter and year-end earnings Wednesday morning. Robert King dives into the trends driving the insurer’s financial performance. Source: Humana Reports Fourth Quarter 2019 Financial Results; Provides Full Year 2020 Financial Guidance

As Cerner reported year-end earnings, executives took some time to discuss the company’s partnership with Amazon and why they see it as key to Cerner’s future growth. As Cerner reported year-end earnings, officials took some time to describe their plans to leverage Amazon’s “deep competencies around the consumer” and “strong interest in being a part of the healthcare ecosystem.” Heather Landi has more. Cerner sees its partnership with Amazon as an opportunity for more than simply moving its services to the cloud. Heather Landi has more on why. Source: Cerner Reports Fourth Quarter and Full Year 2019 Results

The headline on 04 Feb 2020

Former Aetna CEO Mark Bertolini says he’s being pushed out of his role on CVS Health’s board of directors. Source: CVS Health Announces Upcoming Changes to Board of Directors

Help may be on the way for physicians and patients when it comes to the time it takes to get a prior authorization from a health insurer. Source: CAQH CORE Approves Two-Day Rule to Accelerate Prior Authorization Process

It sounds like all good news that the number of nurse practitioners has more than doubled in a seven-year period. But, find out the problem it raises for hospitals. Source: Health Affairs > Implications Of The Rapid Growth Of The Nurse Practitioner Workforce In The US

A federal court lifts a limit on fees physician practices can charge for third-party access to patient records. Heather Landi has the story. Source: Memorandum Opinion (PDF) by U.S. District Court Judge Amit Mehta

Former Aetna CEO Mark Bertolini says he’s being pushed out of his role on CVS Health’s board of directors. Source: CSVHealth > CVS Health Announces Upcoming Changes to Board of Directors

Centene saw significant revenue growth in 2019. Here’s what the company attributes that revenue growth to. (Hint: It’s not its latest acquisition of WellCare Health Plans.) Source: Centene Corporation Reports 2019 Results

The headline on 03 Feb 2020

CMS unveiled policy proposals Friday seeking to curb ACA tax credits. Paige Minemyer has more. Source: CMS.gov > CMS Releases Proposed Notice of Benefit and Payment Parameters Rule for 2021

The novel coronavirus that originated in Wuhan, China — and which prompted U.S. officials to declare a public health emergency — seems to be impacting more adults than children. Source: Time > Why Coronavirus Seems to Be Striking More Adults Than Kids

OptumRx released its latest look at the drug development pipeline. Find out why its experts are warning payers to pay close attention to the growing wave of orphan drug approvals. Source: Optum > Trends to watch in 2020

How bad could the ongoing coronavirus outbreak get? The New York Times examines six critical factors. Source: The New York Times > How Bad Will the Coronavirus Outbreak Get? Here Are 6 Key Factors

Meditech is taking steps to grow its sales even as it faces strong headwinds from hospital consolidation and competition from the likes of Cerner and Epic. Source: Meditech year-end financials report

Despite objections from companies like Epic, more than a few dozen organizations are ramping up pressure for the federal officials to finalize proposed data-sharing regulations. Source: Multistakeholder letter to OMB and HHS on API Access

There’s a deadly virus spreading from state to state, preying on the most vulnerable, striking the sick and the old without mercy. The virus is influenza, and it poses a far greater threat to Americans than the coronavirus currently grabbing headlines around the world. Source: KHN > Something Far Deadlier Than The Wuhan Virus Lurks Near You