Salesforce Expands in Healthcare: Salesforce is enhancing its presence in healthcare by introducing AI tools like Einstein Copilot: Health Actions, aimed at automating clinical summaries and improving patient data insights. The company offers solutions such as Data Cloud for Health and MuleSoft Direct for Health Cloud to integrate data from electronic health records and claims systems.
Private Equity in Healthcare: This was an interesting look from Cardiovascular Business into certain stakeholder commentary on the FTC's workshop on private equity in healthcare. Concerns include potential negative impacts on patient care, competition, and clinician autonomy, with some stakeholders highlighting benefits like increased capital and innovation. Notable voices like Elizabeth Warren (go figure) and multiple state attorneys general brought up the risks of market dominance, higher prices, and reduced care quality, advocating for enhanced regulatory oversight and transparency to protect patient interests.
SCOTUS Reviews DSH Payments Case: The Supreme Court will review a case challenging the HHS formula for calculating Disproportionate Share Hospital (DSH) payments, affecting over 200 hospitals. These hospitals argue that the current method undercounts care provided to Supplemental Security Income (SSI) patients, costing them over a billion dollars annually - potentially altering funding for programs like 340B.
Humana's Value-Based Care Success: Humana published findings this week that its VBC model has led to a 5% reduction in unnecessary hospital admissions among Medicare Advantage members with chronic kidney disease. Since 2019, this approach has lowered the medical expense ratio for these patients by over 12%. Humana collaborates with various partners, including Evergreen Nephrology and DaVita, to manage care for more than 77,000 kidney patients.
SCOTUS Ruling on Medical Debt: The Supreme Court has upheld the Consumer Financial Protection Bureau's (CFPB) funding through the Federal Reserve, rejecting a challenge that could have disrupted its operations. This decision allows the CFPB to continue targeting aggressive medical debt collection practices, protecting over 100 million patients from potential financial harm. Proposed regulations include barring medical debt reporting to creditors and employers, which would safeguard consumers' creditworthiness and reduce the financial burden on those with healthcare debt.
FDA Expands RSV Vaccine Eligibility: The FDA has expanded the approval of GSK's respiratory syncytial virus (RSV) vaccine, Arexvy, to include adults aged 50 to 59 who are at risk of severe illness.
Cone Health's $100M Turnaround: A good look from Beckers inside Cone Health's $100M financial turnaround including reduction of contract labor (probably the biggest lever here), hiring international nurses, and outsourcing certain staff functions.
Rise in Cancer Incidences: A cohort study analyzing cancer incidence trends across successive social generations in the U.S. found significant increases in cancer rates among Generation X (born 1965-1980) compared to previous generations. While lung and cervical cancers have decreased, other cancer types have seen notable rises.
Supreme Court on Mailed Abortion Pills: The Supreme Court unanimously upheld the legality of mailing abortion pills, rejecting challenges that sought to limit access to mifepristone, a commonly used medication for terminating pregnancies.
Michigan Insurer Drops Weight-Loss Drugs: Michigan's Blue Cross Blue Shield announced it will stop covering weight-loss drugs, including popular medications like Wegovy and Saxenda, starting in 2024. It'll affect around 10,000 people and maybe we're starting to see the shiny GLP-1 object lose its luster a bit also given this BCBS report on real-world trends in GLP-1 treatment persistence describing 6 in 10 adults discontinue GLP-1s before seeing any clinical benefit.
Notable TEAM Model Comments: The proposed Transforming Episode Accountability Model (TEAM) by CMS has sparked significant feedback. Stakeholders, including hospitals and physician groups, oppose making the model mandatory, citing concerns over increased administrative burdens and financial strain, particularly for rural and safety-net hospitals. Key suggestions include making the model voluntary, extending the transition period to financial risk, and revising benchmarks and risk adjustment methodologies to better reflect diverse care scenarios (McDermott+Consulting).
IVF Morally Acceptable: A Gallup poll reveals that 82% of Americans consider in vitro fertilization (IVF) to be morally acceptable, reflecting broad societal support for the procedure. The poll comes at a similar timeframe to some shenanigans between Senate Republicans & Democrats around a divided IVF bill.
IU Health Removes Noncompete Clauses: In a fascinating move, IU Health will eliminate noncompete clauses from contracts with primary care providers, effective December 15, 2024. This change follows state legislation banning such clauses in new provider contracts and aligns with the Federal Trade Commission's stance against noncompete agreements. IU Health must have looked up and said "well we control most of the market anyway, wouldn't hurt to throw the FTC a bone."
Decent Health's Comeback: This Fierce article was a good look at Decent Health, after a major setback in January 2023, has relaunched with a new strategy focusing on level-funded employer health plans centered around direct primary care. The approach enables Decent to offer health plans that are 40% less costly than traditional options, aiming to serve small and medium-sized companies. The company's efforts include partnerships with One Medical and Hint Health.
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