Weekly Roundup – June 24, 2023
Welcome to our Healthcare IT Today Weekly Roundup. Each week, we’ll be providing a look back at the articles we posted and why they’re important to the healthcare IT community. We hope this gives you a chance to catch up on anything you may have missed during the week.
Patients in All Demographics Appreciate Online Payment Options. Ben Broseke at Orthopaedic Institute of Ohio told John Lynn how the practice saved 25% after implementing online payment services, with patients young and old using the service in place of paper billing – once they realized the service was legitimate. Read more…
One Health System...
Source: EMR and HIPAA - June 24, 2023 Category: Information Technology Authors: Brian Eastwood Tags: Healthcare IT Healthcare IT Today Weekly Roundup Source Type: blogs
What happens when Rx price bubbles (such as on insulin) burst?
In the first half of 2023, Americans witnessed evidence of a rather fundamental shift in the manner pharma had traditionally opted to commercialize selected prescription drugs. Specifically, in March 2023,Lilly,Novo Nordisk andSanofi each announced they planned to slash insulin list prices for insulin. To do so, they would disintermediate PBMs from the transaction and " opt out " of the PBM commercialization channel.The decision wasn ' t really all that difficult; for years branded insulin-makers had been complaining that PBMs and other drug distribution system entities had been gobbling up an ever-larger share of their re...
Source: Scott's Web Log - June 19, 2023 Category: Endocrinology Tags: 2023 Source Type: blogs
Fight Aging! Newsletter, June 19th 2023
In conclusion, among Swedish middle-aged subjects, nearly two-thirds showed complete fatty degeneration of thymus on CT.
Age-Related Dysfunction of Water Homeostasis
https://www.fightaging.org/archives/2023/06/age-related-dysfunction-of-water-homeostasis/
Dehydration can be an issue in older people. As in every complex system in the body, the mechanisms by which hydration is regulated become dysfunctional with advancing age. Researchers here look at the brain region responsible for regulating some of the response to dehydration, cataloging altered gene expression in search of the more important mechan...
Source: Fight Aging! - June 18, 2023 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
The cost of costs
The reason insurers impose deductibles and copays is to discourage utilization. They believe, no doubt correctly, that if people have to spend their own money they may choose not to get as many medical services or buy as many medications. The problem with this reasoning is that people aren ’t wise shoppers for medicine. Now, I’ll be the first to shout it from the rooftops that as a nation, we spend far too much on medical services that are low value or worthless. In fact, I will do so (metaphorically) later in this book. But it’s not because consumers of medicine aren’t wise s hoppers, and making them pay out...
Source: Stayin' Alive - June 17, 2023 Category: American Health Source Type: blogs
Notes from the 2023 Age-Related Disease Therapeutics Summit
The former Longevity Therapeutics conference series was renamed to the Age-Related Disease Therapeutics Summit and held its fifth event recently in San Francisco. It was a smaller meeting than in past years, perhaps a result of the recent downturn in the global financial and investment environment. Few investors were present. Nonetheless, one can usually learn something interesting from the presenting biotech founders and executives. I took a few notes while I was there to present on progress at Repair Biotechnologies, and they follow in the order of the conference program.
Birget Schilling from the Buck Institute f...
Source: Fight Aging! - June 16, 2023 Category: Research Authors: Reason Tags: Longevity Industry Source Type: blogs
So Many Records, So Little Time: How to Manage Burgeoning Health Plan Requests
Conclusion
Health plans typically request records required to process or resolve claims, perform risk adjustment reviews, and comply with HEDIS reporting requirements. The purpose is justified. It’s the recent rise in medical request volume that has created significant administrative burden and cost for healthcare providers.
Now is the time for providers to seriously consider automating their procedures and processes for fulfilling health plan medical record requests. Volumes are rising, and thankfully help is at hand.
About Moliehi “Mo” Weitnauer
Mo Weitnauer is the Chief Product Officer at MRO where she is...
Source: EMR and HIPAA - June 15, 2023 Category: Information Technology Authors: Guest Author Tags: Administration Ambulatory C-Suite Leadership Health IT Company Healthcare IT HIM Hospital - Health System IT Infrastructure and Dev Ops Revenue Cycle Management Claims Denials Health Data Exchange Healthcare Scene Featured HEDIS Source Type: blogs
Better Health Care Tests, Faster
This article looks at some specific problems and solutions.
Speeding up Test Development
We’ve seen with COVID-19 how quickly a virus can evolve and how hard it is to design both tests and vaccinations that accommodate different variants. Virax Biolabs uses data from the World Health Organization and others to develop tests quickly. For instance, new viral variants tend to spread in the southern hemisphere before hitting the northern hemisphere in our Winter, so Virax can check existing data to prepare better tests for the North.
The company is developing a T-cell diagnostics and profiling platform called Virax Immu...
Source: EMR and HIPAA - June 13, 2023 Category: Information Technology Authors: Andy Oram Tags: Health IT Company Healthcare IT Hospital - Health System Interoperability CLIA COVID-19 Hydreight Immunexpress ixlayer Laboratories Labs Rolland Carlson Sepsis Sepsis Lab Tests Septicyte Shane Madden testing Tomasz George Source Type: blogs
Free Download of The Capitol Forum's Report: " Exclusive Drug Dealing: Anticompetitive Practices in the Pharmaceutical Supply Chain "
In 2020, I wrote a blog post entitled " It ' s the Rx rebates, stupid! " (seehttps://blog.sstrumello.com/2020/09/its-rx-rebates-stupid.html for the post) in which I revealed the reason everyone was overpaying for insulin was because of rebating paid by insulin-makers to secure PBM formulary placement. Novo Nordisk revealed to its investors that it was spending 74% of its gross U.S. sales in the form of legally-exempted rebate kickbacks paid to PBMs. The good news is thanks to a series of actions by a number of different parties, the insulin PBM rebate price bubble finally burst whenLilly, followed byNovo Nordisk and thenSa...
Source: Scott's Web Log - June 11, 2023 Category: Endocrinology Tags: 2023 Exclusive Drug Dealing: Anticompetitive Practices in the Pharmaceutical Supply Chain report The Capitol Forum Source Type: blogs
Dexcom Pays PBMs Kickbacks to Exclude Rival CGMs; Senseonics Found a Way Around That
This week (on June 3, 2023), there was an interestingannouncement from the Maryland-based medical device startupSenseonics, Inc. that UnitedHealthcare will begin providing coverage for theEversense E3 CGM System effective July 1, 2023 for people with Type 1 and insulin-requiring Type 2 diabetes. You may recall that Senseonics received a cash-infusion financial lifeline from Ascensia Diabetes Care back on August 10, 2020 (see the news release for that athttps://www.businesswire.com/news/home/20200810005677/en/Senseonics-Announces-Strategic-Collaboration-with-Ascensia-Diabetes-Care for more) when that company effectively pai...
Source: Scott's Web Log - June 7, 2023 Category: Endocrinology Tags: 2023 Ascensia bribes CGM Eversense Formulary Exclusion kickbacks PBM Senseonics Source Type: blogs
Case of the Week 718
Welcome back to our first case of the month, with a special case from Idzi Potters and theInstitute of Tropical Medicine, Antwerp. The following structures were found in a bronchoalveolar lavage from a middle-aged Belgian patient with asthma who presented with increased shortness of breath. He reports no travel out-of-country and works as an administrator at an insurance company. He recently reported an insect infestation in his home.Video credits are for Monique Vatlet (CHU Ambroise Par é, Mons, Belgium).Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - June 5, 2023 Category: Parasitology Source Type: blogs
Podcast Episode Recommendation: Dear Diabetes Podcast with hostess Rene é Rayles Episode 7
The Dear Diabetes Podcast with hostess Rene é Rayles is a relatively new podcast covering the subject of diabetes; it began quite recently on March 29, 2023. However, Reneé Rayles recently interviewed Civica, Inc. ' s current CEO Ned McCoy. Recall that on June 1, 2023, Ned McCoy succeeded Martin VanTrieste as Civica ' s President and CEO (see the press release athttps://www.businesswire.com/news/home/20220524005169/en/Civica-Announces-Leadership-Transition for details). She spoke with Mr. McCoy about the company ' s affordable insulin biosimilar effort, which is proceeding according to planCivica has released...
Source: Scott's Web Log - June 2, 2023 Category: Endocrinology Tags: 2023 Civica CivicaRx CivicaScript Dear Diabetes Podcast podcast episode recommendations Rene é Rayles Source Type: blogs
Humira Biosimilar Gross-to-Net Pricing Bubble Was Preceded by the Same Pricing Bubble Burst for Insulin Just Months Ago
Today ' s post is not about diabetes per se, although there IS a diabetes connection. But this morning, the big news was that a biosimilar of Abbvie ' s blockbuster anti-inflammatory biologic Humira will be sold byMark Cuban Cost Plus Drug Company (see the press release athttps://www.globenewswire.com/news-release/2023/06/01/2680351/33333/en/Mark-Cuban-Cost-Plus-Drug-Company-joins-forces-with-Coherus-to-make-YUSIMRY-a-HUMIRA-biosimilar-available-to-patients.html for more) at what amounts to an 85% discount to the innovator drug. Mark Cuban Cost Plus Drug Company announced the Humira biosimilar on social media today. See th...
Source: Scott's Web Log - June 1, 2023 Category: Endocrinology Tags: 2023 Abbvie Biosimilar drug discounts gross-to-net bubble Humira insulin Source Type: blogs
A Data Network to Tackle Real-Time Eligibility and Claims Along with Many Other Health Data Problems
Two of the biggest billing problems in U.S. healthcare involve coverage, eligibility and claims. First of all, will the insurer pay for the treatment the doctor requests? Second, how much is covered and how much does the patient have to pay out-of-pocket?
Avaneer Health, a company created by a consortium of major payers and health care providers, is trying to solve these problems and other administrative inefficiencies once and for all. Moreover, the network and platform they have created can solve many of the data sharing issues in healthcare because you connect once to the network and you’re plugged in to the entire ne...
Source: EMR and HIPAA - June 1, 2023 Category: Information Technology Authors: John Lynn Tags: Analytics/Big Data Health IT Company Healthcare IT Hospital - Health System Interoperability Revenue Cycle Management Avaneer Health Health Data Sharing Healthcare Billing Healthcare Claims Healthcare Eligibility Healthcare IT Video Source Type: blogs
Caremark's President Speaks at'Forum 2023 '
David Joyner is President& EVP of CVS ' Caremark PBM business. Caremark refers to that event and business as " Payor Solutions " whose website is athttps://payorsolutions.cvshealth.com/. Truth be told, CVS Caremark would rather patients whose insurance use Caremark as their PBM do not know what the PBM ' s executives say or do behind their veil of secrecy.On May 5, 2023, the Caremark PBM business of CVS Health hosted an event it called " Forum 2023 " , and Mr. Joyner gave a presentation on " What ' next for payors " . It was rather amusing that CVS Health said: " though the [PBM] system is working – from claim adjudi...
Source: Scott's Web Log - May 31, 2023 Category: Endocrinology Tags: 2023 Aetna Caremark CVS Caremark CVS Health David Joyner Payor Solutions Source Type: blogs
Denial
I don ' t remember offhand if I mentioned this in my previous post on the subject, but Sarah Palin ' s grotesque lie about " death panels " also contained a reference to a claim by conservative economist Thomas Sowell:The Democrats promise that a government health care system will reduce
the cost of health care, but as the economist Thomas Sowell has pointed out,
government health care will not reduce the cost; it will simply refuse to pay
the cost. And who will suffer the most when they ration care? The sick, the
elderly, and the disabled, of course. Sowell is obviously an ignorant idiot. As you presumably know...
Source: Stayin' Alive - May 30, 2023 Category: American Health Source Type: blogs
