A Surgical Emergency Exposes the Crisis of the Young and Uninsured When a patient looked anxious before emergency surgery, it turned out he was worried about the hospital bill because he was uninsured. The Doctor Weighs In
Dr. John Frownfelter, MD, FACP, Chief Medical Officer at Jvion In 1852, Mercy Hospital & Medical Center opened as Chicago’s first chartered hospital. In May, it will close, leaving residents of the surrounding South Side community — poor and mostly people of color — without… Read More »What Will It Take for Hospitals to Survive the Pandemic?
The first quarter of 2021 has been one of investor optimism as the vaccine rollout continues ahead of expectations and economic activity begins to accelerate in response. Within the Health IT industry, the already strong investment and M&A trends seen in 2020 have only accelerated. Over the… Read More »Q1 2021 Health IT/Digital Health PC/VE, M&A, IPOs/ SPACs Activity
David Talby, CTO, John Snow Labs Heart disease is the leading cause of death for people of most racial and ethnic groups in the United States. Cardiovascular disease-related deaths—which occur every 36 seconds—cost our country about $219 billion each year, according to the Centers for… Read More »How NLP Can Uncover Social Determinants of Heart Disease
Other blog posts in this series: Segmenting your patient population for the COVID-19 vaccine Engaging patient segments with convenient, secure scheduling solutions Authenticating portal access with automation As the vaccine management process continues to ramp up, providers are focused on how to administer the vaccine… Read More »Q&A: optimizing reimbursements by capturing missed coverage
Why Infertility Treatments Should Be Covered by Insurance Although it’s improving, most insurance coverage for infertility treatment doesn’t match that provided for other conditions. Here’s what you need to know. The Doctor Weighs In
Paul Banco, CEO of etherFAX To support the sudden increase in test results and medical records being transmitted during the pandemic, hospitals, laboratories, and pharmacies implemented additional devices and remote connections into their networks. After the Office for Civil Rights (OCR) lifted penalties around telehealth… Read More »Best Practices to Ensure Telehealth Security and Protect Patient Data
After a scathing report from short-seller Hindenburg claiming that Clover faced a False Claims Act investigation, the insurance startup’s stock plummeted. Clover went public last month after merging with a special-purpose acquisition company under billionaire investor Chamath Palihapitiya.
Irv Lichtenwald, President & CEO of Medsphere Systems Corporation We’re now in a new year and new presidential administration. At least three companies are producing effective COVID-19 vaccines, which are being administered to healthcare workers, teachers, and the elderly. By summer, hopefully a large majority… Read More »Evaluating COVID-19’s Behavioral Health Impact on the Economy
Paula Muto, MD, FACSFounder and CEO, UBERDOC, Inc. We are at a watershed moment. The COVID-19 pandemic has forced us to reevaluate our priorities both economically and with regard to public health. Living with a healthcare system that was created in response to an emergency… Read More »A New System to Fit A New Economy: How Healthcare Can Recover From COVID-19
The Medicare Coverage Gap: What Will the Donut Hole Look Like in 2021? The Medicare coverage gap is present in most Medicare plans,but it’s been getting smaller in recent years. Here’s what to expect in 2021. The Doctor Weighs In
Mike McSherry, CEO & Co-founder of Xealth HIT Consultant sat down with Mike McSherry, CEO, and co-founder of Seattle-based digital prescription platform Xealth to discuss digital health lessons learned in 2020 and what we can expect in 2021. As Xealth’s CEO, Mike also works with… Read More »Xealth’s CEO Shares Impact of Digital Health in 2020 and What’s Ahead in 2021
Lillian Phelps, Sr. Director of Product Management, Availity As the COVID-19 pandemic has gripped the world, many providers have adopted an all-hands-on-deck approach and mentality for treating COVID-19 patients, stretching their resources to the breaking point. We have heard about the frontline heroes who have… Read More »4 Quick Tips for Getting COVID-19 Claims Paid Promptly
Private medical insurance company Further Group has ramped up its presence in digital healthcare by merging with Trustedoctor, a startup that puts patients in contact with medical professionals. Further – which was rebranded from BDU International last year – specialises in providing cross-border health insurance… Read More »Further, Trustedoctor merge to provide ‘borderless’ healthcare
Regence, MultiCare Health System to Deploy HL7 Da Vinci Member Attribution List for Value-Based Care Arrangements
What You Should Know: – Regence and MultiCare ink first-in-the-nation value-based care partnership to deliver improved health outcomes at lower costs. Health insurance provider Regence and MultiCare Health System, an independent accountable care organization (ACO) have partnered to deploy a first-in-the-nation value-based model that delivers… Read More »Regence, MultiCare Health System to Deploy HL7 Da Vinci Member Attribution List for Value-Based Care Arrangements
Verily is planning “significant and focused growth” in 2021 after closing a $700 million funding round from investors including its parent company, and Google holding firm, Alphabet. The capital injection will support wide-ranging plans for the new year that include several life sciences programmes in… Read More »Google’s Verily eyes 2021 growth after £700m funding round
What Will Healthcare Look Like in a Post-COVID-19 World? (Part 1) Notes from HLTH VRTL 2020: The future of healthcare post-COVID and anticipated impacts of changes on the care of autoimmune disease. The Doctor Weighs In
In the 2020 election, Americans nationwide cast their ballots with two major issues on their minds – the economy and coronavirus. Health care specific concerns centered on pre-existing conditions protections and rising out-of-pocket costs exacerbated by declining coverage. But how do these trends compare at… Read More »Election insights: Voter priorities in the states
Don Godbee Don Godbee, Mobile Solutions Architect at Stratix Don Godbee Telehealth and virtual care are not brand-new phenomena suddenly cobbled together as a rapid response to the onset of the COVID-19 pandemic, but the average US patient could be forgiven for thinking that it… Read More »Ensuring Telehealth Providers’ Virtual Care Dollars Make Sense
Healthcare agency, consultancy and digital health group, Healthware, has announced the acquisition of Finland-based digital service development and creative agency Make Helsinki. Healthware strengthens its geographical coverage with the creation of a hub dedicated to the Nordics and Baltics region The deal combines Healthware’s consulting,… Read More »Healthware Group announces acquisition of Make Helsinki
In the Face of a Medicaid Tsunami, Telehealth is More Important Than Ever Telehealth utilization under Medicaid surged during the pandemic providing needed services to the vulnerable. Ongoing funding must be ensured The Doctor Weighs In
Elizabeth Bierbower, Former President of Humana’s Group & Specialty Division Healthcare can achieve optimum efficiency when patients are at the center of care. When patients have the necessary information to navigate their care journey, they will choose the path to high-quality care at the lowest… Read More »COVID-19: How Can Payers Prepare for Mandates and Support Pandemic Relief Efforts
Margarita Alegría, PhD, Chief of the Disparities Research Unit at Massachusetts General Hospital American businesses and their leadership are at a crossroads. COVID-19 has forced us all to re-evaluate how we work and live, while the current protest movements have placed a spotlight on the… Read More »COVID-19 and Racial Disparities: Transforming the Health of Businesses
By ROSEMARIE DAY and NIKO LEHMAN-WHITE One of the most important responsibilities of the American government is to protect its citizens from harmful industry practices, from lead poisoning to dangerous pharmaceuticals to financial meltdowns. Its record is far from perfect, but government regulators usually act… Read More »Election Issue Spotlight: “Junk” Insurance Makes a Pandemic Even Worse
Michael A Greely, Co-Founder & General Partner at Flare Capital Partners This will be ugly and sad. Racism has cost this country $16 trillion over the last twenty years according to a recent Citigroup report. Much of this loss ($13 trillion) was attributed to discriminatory lending… Read More »COVID-19 Pandemic Further Exposes Systemic Racism…
University of Virginia Health System (UVA Health) has gone after patients’ homes to pay for medical bills. Kaiser Health News reports: UVA Health and other medical systems rarely force the sale of a home to claim money. Instead, they wait for families to refinance or… Read More »Health systems seize patients home equity to pay medical bills
CVS Health/Aetna Responds to the Maternal Health Crisis During COVID While not a solution to the maternal health crisis, good communication can help expectant patients feel safe getting care during COVID-19. The Doctor Weighs In
Starship, a startup making Health Savings Accounts easier to use, has seen an influx of users since the start of the pandemic. In the first six months of 2020, the company saw 500% growth in active accounts and plans to double its membership again by… Read More »Starship brings gig economy focus to health savings accounts
Prior authorization is a requirement that health plans require physicians to obtain plan approval in order to prescribe a patient a given medication. Prior authorizations may be put in place to insure medications are not used inappropriately or for payers to try to reduce cost.… Read More »The problem with prior authorization
What You Should Know: – NVIDIA and Massachusetts General Brigham Hospital researchers develop an AI model that determines whether a person showing up in the emergency room with COVID-19 symptoms will need supplemental oxygen hours or even days after an initial exam. – The ultimate… Read More »NVIDIA Develops AI Model to Accurately Predict Oxygen Needs for COVID-19 Patients
The plans will include zero-dollar premiums and will give patients access to free primary care visits, dental exams and lab tests at Walmart Health centers across the state.
What You Should Know: – Anthem extends the use of doc.ai’s platform and portfolio of privacy-first technologies and artificial intelligence software services to drive the personalization of Anthem’s digital assets and create improved value for users. – doc.ai’s product offerings are deployed on its cloud-agnostic… Read More »Anthem Expands Relationship with doc.ai to Power Digital Health Offerings
Finding previously unidentified insurance coverage can feel a little like a game of hide and seek. Patients may not always be aware of their insurance or eligibility for Medicare and Medicaid, and, in an effort to both improve the patient financial experience and simultaneously improve… Read More »Finding unidentified coverage without a Social Security Number (SSN)
Alphabet’s healthcare subsidiary, Verily, will partner with Swiss Re Corporate Solutions to create a new stop-loss insurance company. The new entity, called Coefficient, will use data analytics to help self-funded companies manage unexpected areas of cost.
What You Should Know: – Alphabet’s Verily has established a new subsidiary, Coefficient, with a mission to create value by combining innovative health technology solutions with new insurance and payment models. Verily is the majority shareholder and Swiss Re Corporate Solutions, an established player in… Read More »Verily Forms New Subsidiary Focused on Employer Stop-Loss Through Precision Risk
By KEN TERRY In the strangest healthcare business story of 2020, the major health insurance companies are thriving despite—or because of—the pandemic. As the second quarter reports of United, Anthem, Cigna and other insurers reveal, their COVID-19-related costs were outweighed by the sharp drop in… Read More »Health Insurers Ride High for Now, But Watch What’s Coming Next
Irv Lichtenwald, President & CEO of Medsphere Systems Corporation In the late 1940s, the United Kingdom was busily reassembling country and what remained of the empire in the aftermath of World War II. Among many revelations, the war had convinced Britain’s leaders of the need… Read More »COVID-19 Underscores Why Certain Aspects of the American Healthcare System Should Change Forever
Max Mancini, CTO at Collective Health What You Should Know: – Collective Health appoints Max Mancini as its new Chief Technology Officer. – Mancini, who previously held senior roles at Apple and eBay, will lead the company’s exceptional engineering team- overseeing the architecture, design and… Read More »Collective Health Appoints Max Mancini as New Chief Technology Officer
By KIM BELLARD I’ve been covered by private insurance my entire life. Even more telling, I worked in the health insurance industry for — gasp! — some thirty years. It’s not just paid for my healthcare, it’s financed my life. Today, though, for the first… Read More »Health Insurance Needs to Grow Up
New Long-Term Care Benefits Added to Medicare Advantage Plans Medicare’s coverage of long-term care is limited, but new benefits added to some Medicare Advantage plans will help more seniors to continue to live at home The Doctor Weighs In
David Shelton, PatientMatters CEO In the past few months, the COVID-19 pandemic has shaken societies, economies, and human wellbeing to the core. While protecting public health and welfare are top priorities for hospitals, the harsh reality is that it takes cash to keep the doors… Read More »COVID-19: 4 Essential Patient Payment Strategy Components to Accelerate Cash Flow
UnitedHealth Group saw its earnings nearly double to $6.6 billion during the second quarter, as fewer patients sought out appointments or non-essential procedures due to the pandemic.
– Walgreens will invest $1 billion in equity and convertible debt in VillageMD to open 500 physician-led primary care clinics in more than 30 U.S. markets in the next five years. – VillageMD and Walgreens also recently announced the availability of Village Medical telehealth providers… Read More »Walgreens to Invest $1B in VillageMD to Open 500 to 700 Full-Service Doctor Offices
Walmart quietly launched a new health insurance business. The company, called Walmart Insurance, was filed with the Arkansas Secretary of State last month.