Gist Healthcare Daily: Recent Episodes
Gist Healthcare
Gist Healthcare Daily delivers our take on the top healthcare business and policy news in under 10 minutes Monday through Friday. Host Alex Olgin gives you the “gist” of what’s happening in healthcare across the country so you can start your day informed. Subscribe and listen.
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The Senate’s take on the One Big Beautiful Bill includes bigger cuts to Medicaid, compared to the House’s version. Iowa becomes the latest state to implement stronger restrictions on pharmacy benefit managers. And, 23andme’s former-CEO will now become the buyer of the bankrupt biotech company. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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One of the biggest shows so far this year is the critically acclaimed medical drama The Pitt, which stars Noah Wyle of ER fame. The HBO Max series has been called one of the most accurate descriptions of an emergency department. On today’s episode of the Gist Healthcare podcast, host J. Carlisle Larsen is joined by Sylvia Owusu-Ansah, MD, who served as a medical consultant for the show and contributed storylines. She’s an associate professor of pediatrics and emergency medicine at the University of Pittsburgh School of Medicine and the director of EMS at UPMC Children’s Hospital Pittsburgh.
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Health and Human Services Secretary Robert F. Kennedy Jr. names new members to a CDC vaccine advisory panel days after he removed existing members. UnitedHealth Group’s credit rating is downgraded. And, states sue bankrupt DNA testing company 23andme to protect consumers’ genetic data. Those stories coming up on today’s episode of the Gist Healthcare podcast.
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All 17 experts have been fired from the Centers for Disease Control and Prevention’s independent vaccine panel. A new poll finds that the recent One Big Beautiful Bill Act--and its cuts to Medicaid--is raising concerns among voters. And, digital chronic condition management company Omada Health has had the second splashy digital health IPO in the last month. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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The House of Representatives passed a budget reconciliation bill around Memorial Day that extends tax cuts put into place during President Trumps first term in office, as well as increases border and military spending. However, the bill also includes significant federal healthcare spending cuts, notably in the joint federal-state Medicaid program.
Michael McAuliff covers policy and politics in Washington D.C. for Modern Healthcare. He joins the podcast to talk more about the bill.
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Staffers laid off from the Department of Health and Human Services this spring are suing the Trump Administration and are seeking class action status. The Centers for Disease Control and Prevention contradicts HHS’s recent recommendations for COVID-19 vaccines for children. And, the annual cost of insuring a family tops $35 thousand. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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The Trump Administration releases more a detailed proposed budget for the Department of Health and Human Services for the 2026 fiscal year, including significant cuts to agencies within the department. The FDA rolls out a new artificial intelligence tool. And, hospitals spent billions of dollars to ensure workplace safety in 2023. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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The Department of Health and Human Services cancels Moderna’s multi-million-dollar award to develop an mRNA vaccine for influenza, including bird flu. CVS and Express Scripts sue Arkansas over state law restricting pharmacy benefit managers. And, a new study from Mass General Brigham finds that traditional diagnostic tools outperformed generative AI. Those stories coming up on today's episode of the Gist Healthcare podcast.
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The Trump Administration updates its hospital price transparency rules and seeks public input. The Department of Health and Human Services narrows its COVID-19 vaccine guidance. And ChristianaCare will purchase five Crozer Health facilities. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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A judge blocks the Trump Administration’s reduction-in-force executive order, which includes the Department of Health and Human Services. Virtual physical therapy company Hinge Health has a big IPO. And, a new white paper finds a significant increase in the number of Americans taking blockbuster GLP-1 drugs to manage overweight or obesity. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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Investment banks downgrade UnitedHealth Group amid ongoing challenges. The Food and Drug Administration changes its COVID-19 guidelines, restricting the shots to certain at-risk groups. And, Cigna’s Evernorth subsidiary will cap the cost of pricy weight loss drugs for members. Those stories and more coming up on today’s episode of Gist Healthcare podcast.
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The House Budget Committee moves forward a tax bill with significant cuts to Medicaid. Pennsylvania's governor calls for more oversight of private equity healthcare deals following the closure of Crozer Health. And, Regeneron Pharmaceuticals buys 23andme’s assets for $256 million. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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The United States Supreme Court rules against hospitals in an ongoing case about disproportionate share hospital payments. Aetna announces it will leave the healthcare exchanges. And, Novo Nordisk is partnering with telehealth companies to expand access to its GLP-1 drugs. Those stories and more coming up on today's episode of the Gist Healthcare Podcast.
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The Department of Health and Human Services is facing another legal challenge over its decision to cut funding for public health initiatives. More nurses say they plan to leave the field due to stress and burnout. And, a new study finds that Medicare Part D coverage of popular weight loss drugs could raise costs by billions of dollars. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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The Senate HELP committee report calls for reforms within the 340B drug discount program. Blue Shield of California leaked health data of nearly 5-million members to Google. And, measles misinformation is on the rise nationwide, according to a new poll. That's coming up on today’s episode of the Gist Healthcare podcast.
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The newly established, so-called Department of Government Efficiency is reportedly freezing healthcare grants. Eli Lilly sues telehealth companies over compounded versions of its popular weight loss drug. And, Walgreens settles a case from the federal government in the ongoing opioid crisis. Those stories and more coming up on today’s episode of Gist Healthcare Daily.
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The Supreme Court hears arguments in a case challenging a core part of the Affordable Care Act. Arkansas implements a first-in-the-nation law banning pharmacy benefit managers from owning pharmacies. And, Eli Lilly announces a new oral GLP-1 drug that was successful in lowering blood sugar and weight loss. Those stories and more coming up on today’s episode of Gist Healthcare Daily.
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A leaked document shows the extent of proposed cuts coming to the Department of Health and Human Services. UnitedHealth Group had its worst day on the market in decade after it announced disappointing first quarter results. And, Cone Health has purchased Novant Health's ownership interest in their joint Medicare Advantage business. We get those stories and more coming up on today's episode of the Gist Healthcare podcast.
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Medicare proposes a 2.4% pay increase for inpatient hospitals next year. The Centers for Medicare and Medicaid Services will end some federal Medicaid spending for state programs. And, the ongoing merger between UnitedHealth Group and home health company Amedisys heads to mediation with the Department of Justice. Those stories and more coming up on today's episode of the Gist Healthcare podcast.
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A federal watchdog advises the Department of Health and Human Services to create a plan to deal with drug shortages. A new survey finds broad political support for Medicaid among voters. And a federal judge permanently bars the National Institutes of Health from imposing caps on indirect research costs. Those stories coming up on today’s episode of the Gist Healthcare podcast.
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Congress has passed a budget blueprint that could mean big federal spending cuts for healthcare. President Trump says big tariffs are coming for foreign made pharmaceuticals. And, Idaho becomes the first state in the country to ban vaccine mandates in businesses and schools. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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A second child has died of a measles-related medical complication in Texas, as the number of cases continues to grow nationwide. The Trump Administration reverses a Biden-era proposal that would have allowed Medicare to cover blockbuster GLP-1 drugs for weight loss. And, a federal judge temporarily blocks $11 billion in public health funding cuts to states. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Cybersecurity remains a top concern for many healthcare organizations as attacks continue to increase. On today’s Monday episode of the Gist Healthcare podcast, we hear the second part of host J. Carlisle Larsen’s conversation with Christian Dameff, MD, emergency physician and Co-Director of the University of California-San Diego’s Center for Healthcare Cybersecurity, about takeaways from last year’s cyberattack on the Change Healthcare clearinghouse and how proposed federal legislation regarding healthcare cybersecurity could impact hospitals, especially in rural areas.
You can listen to the first half of the conversation here.
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The Federal Trade Commission has paused its suit against the nation’s biggest pharmacy benefit managers. States sue the Trump Administration after it abruptly cuts $11 billion in funding for public health initiatives. And, Eli Lilly says it is not affiliated with Hims & Hers after the telehealth company announces it will sell the drugmaker’s popular weight loss drug Zepbound. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Layoffs at the Department of Health and Human Services begin. The Food and Drug Administration’s top vaccine official resigns, causing share prices of biotech companies to falter. And, Utah becomes the first state to ban fluoride in drinking water. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The healthcare industry remains the most targeted sector for cyberattacks in the United States. Last year had the dubious distinction of having the most patient records exposed in a year at more than 276 million. It also had the largest healthcare cyberattack on record, when UnitedHealth Group’s Change Healthcare was hacked in February. Though we know that hospitals, vendors, and related organizations are particularly vulnerable to attacks, it’s been difficult to fully secure them.
Christian Dameff, MD, emergency physician and Co-Director of the University of California-San Diego’s Center for Healthcare Cybersecurity, joins host J. Carlisle Larsen to talk more about challenges facing the industry and some common misconceptions about the motivations behind these attacks.
This is a two-part episode. The second half of their conversation will air on Monday, April 7.
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The Department of Health and Human Services will lay off more than 10-thousand employees in the Trump Administration’s latest push to streamline federal agencies. The Senate confirms President Trump’s nominees to lead the National Institutes of Health and the Food and Drug Administration. And, the FBI says it has not found a credible terrorist threat against the nation’s hospitals. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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President Trump nominates acting Centers for Disease Control and Prevention Director Susan Monarez for the permanent role. Cigna finalizes the sale of its Medicare Advantage business in a multibillion dollar deal. And, a new survey finds that a sizeable number of healthcare leaders plan to leave their organizations within the year. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The White House has pulled its pick to lead the Centers for Disease Control and Prevention hours before he was to appear for his confirmation hearing in front of the Senate HELP committee. UnitedHealth Group is the first major insurer to add a new non-opioid painkiller to its formulary. And, a new study finds that women paid nearly $9 billion more for prescription drugs than men last year. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The Trump Administration proposes a new rule that would roll back certain Biden-era flexibilities that allowed more people to enroll in Affordable Care Act plans on the exchanges. Nearly 750 rural hospitals face closure nationwide due to financial problems, according to new data. And, Americans borrowed an estimated $74 billion for medical bills last year. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Walgreens officially will go private in a $10 billion deal with private equity firm Sycamore Partners after months of speculation. The Centers for Disease Control and Prevention is on the ground in Texas as the measles outbreak continues to grow. And, Novo Nordisk drops the price of its popular weight loss drug after a similar move from rival drugmaker Eli Lilly. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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President Trump’s pick to lead the National Institutes of Health faced his first Senate Committee hearing this week. UnitedHealthcare announces it will cut its prior authorizations by 10 percent for certain services. And, the nonprofit Coalition for Health AI has released details of its long-awaited AI model card registry. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The US Department of Health and Human Services scales back a decades-old policy that allows for public comment on healthcare regulations. President Trump issues an executive order on hospital price transparency. And, a new study finds that Black and Hispanic mothers bear the brunt of high maternity care costs. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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House Republicans passed a budget blueprint last Tuesday that includes around $2 trillion in federal spending cuts. That plan includes $880 billion in spending cuts from programs that are overseen by the House Energy and Commerce Committee, a majority of which are anticipated to come from the Medicaid program. Bruce Siegel, MD, MPH, President and CEO of America’s Essential Hospitals, joins host J. Carlisle Larsen to talk about how those expected cuts could impact safety net hospitals nationwide.
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Lawmakers call on the Department of Veterans Affairs to clarify the expected budget for its large-scale electronic health record modernization project. A Texas child dies from a measles infection – the first death from the virus in the United States in a decade. And, Eli Lilly announces plans to invest billions in new United States-based manufacturing plants. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The Department of Justice is reportedly investigating UnitedHealth Group over its Medicare Advantage billing practices. The Centers for Disease Control and Prevention cancels—indefinitely—a meeting of vaccine advisors . And, fatal drug overdoses are down nationwide. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Budget Committee Republicans have tasked the Energy and Commerce Committee with finding $880 billion in cuts to federal healthcare spending. Though the committee has jurisdiction over many programs, it notably oversees Medicare Part B and Medicaid spending. Matthew Fiedler, Senior Fellow at the Brookings Institution, joins host J. Carlisle Larsen to talk about the news and why most of those potential spending cuts could come from Medicaid.
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Biden-era merger guidelines jointly established by the Federal Trade Commission and the Department of Justice remain in place for now. A new study finds that the United States could face a critical hospital bed shortage within the decade. And, the number of measles cases in Texas continues to grow. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The Trump Administration to lays off thousands of the Department of Health and Human Services employees, including more than 1,000 at the Centers for Disease Control and Prevention. The administration cuts around 90 percent of the budget meant for Affordable Care Act marketplace navigators. And, flu deaths surpass those related to COVID-19 for 1st time since the beginning of the pandemic. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Following the COVID-19 pandemic, UMass Memorial Health in Worcester, Massachusetts began to pilot a new hospital-at-home program: one for postpartum patients. Benjamin Hamar, MD, Director of the Maternity Center at UMass Memorial and a member of the Maternal-Fetal Medicine Division, joins the podcast to tell host J. Carlisle Larsen more about the first-in-the-nation model.
This episode originally aired on November 4, 2024.
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Robert F. Kennedy Jr. Is confirmed as the next Secretary of the Department of Health and Human Services. House Republicans outline $880 billion in healthcare cuts. And, the American Hospital Association calls on the Trump Administration to exempt medical devices from tariffs. That's coming up on today’s episode of the Gist Healthcare podcast.
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A federal judge has issued a temporary stay on funding cuts to research institutions from the National Institutes of Health. The Department of Health and Human Services has been ordered to restore health information webpages following a lawsuit. And, a new study finds that using a popular weight loss drug can help patients lower their need for blood pressure medications. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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A recent $10 million endowment to Northwestern’s Kellogg School of Management will establish a new Healthcare Leadership Center in partnership with Northwestern Medicine. The goal of the center is to train the next generation of healthcare leaders in an ever-evolving healthcare landscape. Craig Garthwaite, Professor of Strategy and the Director of Healthcare at Kellogg, joins host J. Carlisle Larsen to talk more about the goals of the center. He also shares his thoughts on the challenges facing the industry.
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Elon Musk’s aides at the Department of Government Efficiency are reportedly probing Medicare payment systems for fraud. Physicians sue the Trump Administration over the scrubbing of health information from federal websites. And, maternal mortality is declining except among Black women. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Members of the Senate Finance Committee have advanced Robert F. Kennedy Jr.’s nomination to lead the Department of Health and Human Services to the full Senate. New legislation introduced in Congress would raise Medicare physician pay if it’s passed. And, the Food and Drug Administration has approved the first non-opioid prescription painkiller in more than 20 years. We'll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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On today’s episode of the Gist Healthcare podcast, we hear the second half of host J. Carlisle Larsen’s conversation with Modern Healthcare’s Michael McAuliff about a document making the rounds on Capitol hill that outlines potential federal healthcare spending cuts.
You can find the first part of their conversation here.
And, you can read Michael’s recent article about the proposed federal healthcare cuts here.
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The Trump Administration reverses course on a federal funding freeze memo that threw healthcare programs into chaos nationwide. Cigna announces plan to lower out-of-pocket prescription costs for members. And, the FDA approves Ozempic to treat diabetic kidney disease. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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UnitedHealth Group reveals that the number of Americans impacted by last year’s Change Healthcare breach has nearly doubled. The University of Minnesota and Essentia Health announce a plan to form a new nonprofit healthcare entity. And, Walgreens rumored sale of itself to a private equity firm is reportedly called off. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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A document making the rounds in Congress outlines trillions of dollars in potential federal spending cuts to pay for an extension of tax cuts put into place during President Trump’s first term. And Healthcare makes up a sizable part of the proposed cuts. Michael McAuliff, politics and policy reporter for Modern Healthcare, joins host J. Carlisle Larsen to talk more about what healthcare programs could face spending cuts and reactions from lawmakers on Capitol Hill.
You can find Michael’s recent article about the proposed healthcare cuts here.
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The Trump Administration has paused federal health agencies’ external communications, pending a review. The Affordable Care Act saw record enrollment for the 2025 plan year on the exchanges, but that growth could be stymied if enhanced tax subsidies expire at the end of the year. And, RSV antibody shots given to mothers during pregnancy have been found to significant cut infection risk in infants. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Newly inaugurated President Trump has issued sweeping initial healthcare orders for his second term. The Department of Health and Human Services releases the next 15 Medicare Part D drugs chosen for negotiations with a blockbuster GLP-1 weight loss drug at the top of the list. And, a new report from a federal watchdog raises red flags over the Food and Drug Administration’s accelerated approval process for experimental drugs. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The Biden Administration finalizes rule allowing practitioners to prescribe certain drugs for opioid use disorder via telehealth appointments. Fewer new Black and Hispanic students are enrolling in medical school following Supreme Court ruling that effectively stuck down Affirmative Action. And, the Centers for Medicare and Medicaid Services retracts recently released Medicare Advantage enrollment data. That's coming up on today’s episode of the Gist Healthcare podcast.
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The Supreme Court says it will consider a broad lawsuit challenging the Affordable Care Act’s preventive care mandate. The Biden Administration will crack down on health insurance exchange brokers in a final rule issued this week. And, Walgreens’ CEO confirms plans to sell VillageMD. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The man accused of killing UnitedHealthcare’s CEO has been extradited to New York on murder charges. National healthcare spending hit $4.9 trillion in 2023, likely due to increased utilization and intensity. And, the Centers for Disease Control and Prevention reports first severe human case of bird flu in the United States tied to a backyard flock. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare
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Congress is another step closer to finalizing a year-end spending package to keep the government operating, and the plan includes some significant healthcare related spending. The Health Resources and Services Administration demands the French drugmaker Sanofi abandon its controversial 340B credit model. And, fewer children are being vaccinated against the flu. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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President-elect Donald Trump has named a number of high-profile individuals to lead federal healthcare agencies. These include Robert F. Kennedy Jr. To lead the Department of Health and Human Services, and Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services. On today’s episode, host J. Carlisle Larsen speaks with POLITICO’s Ben Leonard to talk more about his healthcare choices, their chances of getting confirmed by the Senate, and what his picks could signal about his second administration’s priorities.
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United States Senators introduce legislation that would break up healthcare giants’ pharmacy benefit managers. Walgreens is reportedly looking into a sale to a private equity firm and going private. And, a new poll finds fewer than one in five Americans are satisfied with the cost of healthcare. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Police arrest suspect in the murder of UnitedHealthcare CEO Brian Thompson. Anthem Blue Cross Blue Shield backtracks on a controversial planned cap on anesthesia payments. And, dozens of Nobel laureates write to the US Senate urging lawmakers to oppose Robert F. Kennedy Jr.’s nomination to lead the Department of Health and Human Services. We’ll get those stories coming up on today’s episode of the Gist Healthcare podcast.
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Since January 2021, hospitals and health systems have been required to post the prices of standard charges publicly. The goal of the Hospital Price Transparency Rule has been to increase competition and bring down the cost of healthcare for consumers. Since the regulation went into effect three years ago, researchers at Turquoise Health wanted to see if the market had responded.
Carol Skenes, Interim Vice President of Product at Turquoise, joins host J. Carlisle Larsen to talk about what their researchers found after reviewing industry-wide data.
You can find the white paper discussed on today’s episode here.
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UnitedHealthcare CEO Brian Thompson's killing in Manhattan this week sends shockwaves through the industry. Cone becomes the latest health system to join Kaiser Permanente’s Risant Health system. And, CMS proposes new guidelines regulating Medicare Advantage prior authorizations and advertisements. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Sanofi becomes the latest pharmaceutical company to introduce a rebate model for 340B-eligible healthcare organizations. A new rule proposed by the Biden Administration would allow Medicare and Medicaid to cover drugs like Ozempic for weight loss. And, patients with HIV can now donate and receive organ transplants from other individuals with the disease. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare
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On this week’s Monday interview, host J. Carlisle Larsen speaks with Kaufman Hall’s Scott Christensen about trends within the retail healthcare delivery space and what hospitals can learn from these organizations’ stumbles and successes.
You can find the first part of our conversation here. And you can read Scott’s recent blog post about the topic here.
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President-elect Trump taps former-TV personality Dr. Oz to lead the Centers for Medicare and Medicaid Services. The parent companies of major U.S. pharmacy benefit managers sue the Biden Administration over a recent suit brought by the FTC alleging that PBMS engage in anticompetitive rebate practices for insulin. And, CMS will lower importance of the call center metric in Medicare Advantage star ratings. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Incoming President Donald Trump is reportedly weighing significant changes to Medicaid, and some states are rushing to get their waiver requests in before President Biden leaves office. UnitedHealth Group announces Change Healthcare’s clearinghouse services are fully operational following a massive cyberattack on the company earlier this year. And, nearly 10,000 Corewell nurses in southeast Michigan will unionize. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare
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Retailers have made a big splash in the healthcare delivery space over the last decade, but many have seen mixed success with their healthcare business. Some companies, including CVS and Amazon, are still making progress. While others, like Walmart and Walgreens, have taken a tumble. On today’s episode of the Gist Healthcare podcast, host J. Carlisle Larsen discusses what we’ve seen in the retail space with Scott Christensen, Senior Vice President for Kaufman Hall’s Strategy and Business Transformation team.
Scott recently wrote a blog post analyzing the retail healthcare business, read it here.
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President-elect Donald Trump nominates Robert F. Kennedy Jr. as the next Secretary of the Department of Health and Human Services. And the Biden Administration sues to halt Optum’s multibillion dollar acquisition of home health provider Amedisys on antitrust grounds. We get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Cigna confirms it is not pursuing an acquisition of rival health insurer Humana. OptumHealth and Aetna agree to settle a class action lawsuit alleging that they billed health plan members for administrative fees coded as medical expenses. And, hospital-associated infection rates are down, according to recent data from the CDC. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare
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- General Catalyst’s HATco signs a definitive agreement to purchase Akron, OH-based Summa Health. The Food and Drug Administration plans to remove a common—but ineffective—decongestant ingredient from the market. And, more young people are landing in the emergency department for consuming too much caffeine. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare
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Share prices of Medicare Advantage health insurers jump following former-President Trump’s victory in the 2024 presidential race. Novant Health completes its acquisition of 200-provider group from a South Carolina health insurer. And, Medicaid’s gross spending on GLP-1 drugs grew by 500% over a four-year period. We’ll get that story—and more—coming up on today's episode of the Gist Healthcare podcast.
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Physicians are facing a Medicare pay cut again in 2025 and are calling on Congress to fix the issue. Virtual mental health provider company Cerebral has reached an agreement with the federal government to pay fines tied to allegations that it overprescribed controlled substances, like Adderall. And, a smaller proportion of healthcare workers have received the latest COVID shot. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Following the COVID-19 pandemic, UMass Memorial Health in Worcester, Massachusetts began to pilot a new hospital-at-home program: one for postpartum patients. Benjamin Hamar, MD, Director of the Maternity Center at UMass Memorial and a member of the Maternal-Fetal Medicine Division, joins the podcast to tell host J. Carlisle Larsen more about the first-in-the-nation model.
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Medicare’s largest accountable care program saved the federal government more than $2 billion dollars last year. CVS bucks the retail-healthcare contraction trend and announces expanded primary care services for its Aetna members at its MinuteClinic locations in certain markets. And, Cigna’s CEO brushes off Humana purchase rumors in a call to investors. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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A government watchdog finds that Medicare paid health insurers billions for what it says were questionable home diagnoses. UnitedHealth and home healthcare company Amedisys are reportedly appealing to regulators in an effort to finalize their proposed multi-billion-dollar merger. And, Novo Nordisk wants to block compounding pharmacies from creating Ozempic knockoffs. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The Medicare Advantage market has seen unprecedented growth in recent years, with a majority of Medicare eligible beneficiaries enrolling in one of these privately administered plans in 2024. But over the past couple of years, the industry has experienced some growing pains—ranging from more regulatory scrutiny to higher costs associated with members utilizing more healthcare services.
In the second half of their conversation, Joyjit Saha Choudhury, Managing Director of the Kaufman Hall’s Strategy and Business Transformation practice, joins host J. Carlisle Larsen to talk about the potential worst-case scenario for the market.
You can find the first part of their conversation here.
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The February cyberattack on Change Healthcare could have compromised the data of 100 million people, making it the largest healthcare data breach reported to the federal government. The Cleveland Clinic and Amazon to partner on primary care clinics in Ohio. And, Senators want more information from Eli Lilly and Pfizer about their direct-to-consumer platforms. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Cigna and Humana have reportedly resumed merger talks after abandoning plans late last year. Walgreens is looking at a healthcare future without VillageMD as a key component. And, Blue Cross Blue Shield will pay roughly $2.8 billion to settle a class action antitrust case brought by providers. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Enrollment in Medicare Advantage plans surpassed 54 percent for the 2024 plan year, as more eligible seniors seek to take advantage of the privately administered health plans. Though MA plans have become increasingly popular, the industry has had some growing pains, ranging from increased regulatory pressures and higher consumer medical utilization.
On today’s episode of the Gist Healthcare podcast, Joyjit Saha Choudhury joins host J. Carlisle Larsen to talk about his recent piece, Preparing for Medicare Advantage’s Make-or-Break Moment.
The second part of their conversation will be available on Monday, October 28.
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UnitedHealth Group’s stock tumbles as it reveals a jump in medical costs hurt its 2025 profit outlook. More than 1,500 physicians call on the Trump campaign to release an outline of healthcare plans after the former-president said he wants to replace the Affordable Care Act. And, the Food and Drug Administration halts the clinical application of Novavax’s combination COVID-influenza shot, following a report of a significant reaction from a trial participant. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Medicare Advantage star ratings drop for the 2025 plan year, as expected. Walgreens plans to close more stores as the company continues to right its finances. And, the largest maker of IV fluid in the United States looks to import fluid from abroad to mitigate a hurricane-related shortage. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Nearly 80 percent of registered voters in the United States say that healthcare is either an extremely or very important issue, according to a recent Gallop poll. On today’s episode of the Gist Healthcare podcast, we take a look at some of the healthcare issues that have become platforms for the presidential tickets, as well as how some down ballot races are approaching healthcare policy. Dan Diamond, national healthcare reporter for the Washington Post, joins us to talk healthcare policy and politics.
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The nation’s largest producer of I-V fluids is expanding allocations of its products to meet demand from hospitals in the aftermath of Hurricane Helene. UnitedHealth Group, Cigna, and CVS have asked a judge to remove FTC Chair Lina Khan and two other commissioners from the agency’s insulin price antitrust suit. And, interviews are making their return to the podcast. Stay tuned to learn about what’s on the docket. These stories—and more—coming upon today’s episode of the Gist Healthcare podcast.
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Democratic presidential candidate Kamala Harris proposes an expansion of Medicare’s home healthcare policy. The Government Accountability Office says the Centers for Medicare and Medicaid Services should be more diligent in ensuring hospitals are compliant with price transparency rules. And, some hospitals in Florida prepare to close facilities and evacuate patients as Hurricane Milton barrels through the Gulf. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Hospitals around the country are reporting shortages of crucial IV fluid in the aftermath of Hurricane Helene. Not-for-profit hospitals add ten times their value to communities relative to their tax breaks, according to a new report. And, the Federal Trade Commission could wade into the legal fight between startup Particle Health and the nation’s largest EHR vendor Epic. That story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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The Vice Presidential candidates squared off this week and healthcare policy took center stage. Humana’s stock drops following news that federal regulators slashed the number of the company’s enrollees in high-star Medicare Advantage plans. And, the number of reported whooping cough cases has spiked this year. We’ll get that story--and more--coming up on today’s episode of the Gist Healthcare podcast.
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CVS is rumored to be weighing breaking up its retail and insurance businesses amid investor pressure. Johnson & Johnson is abandoning its controversial 340B drug discount rebate plan. And, The Biden Administration is no longer pursuing its push for greater Medicaid drug price transparency, according to a report. We’ll get that story--and more--coming up on today’s episode of the Gist Healthcare podcast.
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New legislation is introduced in the United States Senate that sets standards for healthcare cybersecurity. The Centers for Medicare and Medicaid Services finalizes national Medicaid renewal compliance deadlines. And, Novo Nordisk’s CEO blames health insurers and PBMs for the high cost of its blockbuster weight loss drug Ozempic. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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New legislation introduced this week in the US Senate would make ACA expanded subsidies permanent. Employers expect an increase in per employee healthcare benefit spend in 2025, according to a new survey. And, EHR giant Epic sued over allegations of anticompetitive business practices. We’ll get that story and more coming up on today’s episode of the Gist Healthcare podcast.
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A bill introduced in Congress would exempt some smaller drugmakers from the Medicare drug price negotiation process. The Federal Trade Commission sues the nation’s largest pharmacy benefit managers over the cost of insulin. And, consumers will be able to self-administer a nasal flu vaccine next year. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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- A move to extend pandemic-era telehealth and hospital-at-home flexibilities passes out of a key Congressional committee. Another major health insurer plans to scale back their Medicare Advantage offerings for the upcoming plan year. And, drug overdose deaths in the US are declining rapidly, according to data from the CDC. We’ll get that story--and more--coming up on today’s episode of the Gist Healthcare podcast.
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The Health Resources and Services Administration threatens sanctions against Johnson & Johnson over the company’s decision to change how hospitals are provided 340B discounts on some prescription drugs. And, a summer surge of COVID infections could be abating...We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Rural hospitals are reportedly not taking advantage of free help from technology companies. A major pharmacy benefit manager sues the Federal Trade Commission over a recent...damning report of the business. And, a new survey indicates that the physician shortage could be getting worse. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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UnitedHealthcare unveils a new “gold card” program for providers to make the prior authorization process more efficient. The Centers for Medicare and Medicaid Services suspends two ACA platforms over concerns that foreign entities had access to consumer information. And, the FDA OKs the first over-the-counter hearing aid software for use with Apple Air Pods. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.
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Healthcare was a hot topic during this week’s presidential debate...especially the past and potential future of the Affordable Care Act. The data of nearly 1 million Medicare beneficiaries could have been exposed to hackers through a software vulnerability discovered last year. And, hospitals experienced a slight labor rebound in August. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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The Biden Administration finalizes new mental health parity rules for insurers. A large-scale study suggests that the active ingredient in the blockbuster weight loss medicine Ozempic reduced the risk of severe COVID reactions among patients with obesity. And, we’ll get some more top news in heathcare. That's coming up on today's episode of the Gist Healthcare podcast.
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Several high-ranking executives at Walgreens are being sued by a shareholder as the retail pharmacy’s stock price continues to drop. Humana will exit 13 Medicare Advantage marketplaces ahead of the 2025 plan year. And, we’ll get some more top healthcare news headlines. That’s coming up on today’s episode of the Gist Healthcare podcast.
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Johnson & Johnson draws the ire of hospitals and the government over a planned change to how it will provide discounts for some of its 340B-eligible drugs. Pfizer becomes the second drug company to get into the direct-to-consumer market. Those stories and more coming up on today’s episode of the Gist Healthcare podcast.
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Struggling Steward Health Care will sell six of its Massachusetts hospitals. Kaiser Permanente backed Risant Health plans to invest more than $1 billion dollars in Cone Health. And, pharmacy benefit manager leaders could be in hot water following testimony over their business practices on Capitol Hill. That’s coming up on today’s episode of the Gist Healthcare podcast.
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A new report projects the average cost of employer-sponsored health plans to rise 9 percent next year. The Centers for Medicare and Medicaid Services receives 12,000-plus complaints about No Surprises noncompliance. And, the FDA approves a chemo-free treatment for a common type of lung cancer. That’s coming up on today’s episode of Gist Healthcare Daily.
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A federal judge blocks the FTC’s ban on noncompetes. And, New Jersey’s governor says about $100 million dollars in residents’ medical debt will be eliminated. That’s coming up on today’s episode of Gist Healthcare Daily.
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Massachusetts’ governor arranges deals to force the sale of five Steward Health Care hospitals in the state. As Medicare Advantage enrollment grows, a new report warns of the program’s impact on hospital margins. And Eili Lilly's GLP-1 weight-loss drug reduces the risk of developing type 2 diabetes. That’s coming up on today’s episode of Gist Healthcare Daily.
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A Texas court overturns a HHS change to how Medicare pays hospitals that serve large numbers of low-income patients. Medical-cost fiduciary litigation is on the rise. And the FDA authorizes the first over-the-counter, at-home syphilis test. That’s coming up on today’s episode of Gist Healthcare Daily.
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Biden’s nursing home staffing mandate gets hit with another lawsuit. This one from the Texas attorney general. Eli Lilly takes action to halt the sales of copycats of its GLP-1 drugs. And Kentucky is the first state to decriminalize medical errors. That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS releases results from its first Medicare prescription drug price negotiations under a new federal program. The WHO declares mpox a global public health emergency. And Elevance Health closes a deal with a private equity firm to create a primary care company. That’s coming up on today’s episode of Gist Healthcare Daily.
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Steward Health Care signs a definitive agreement to sell its physician group. President Biden announces $150 million dollars in federal awards as part of his “cancer moonshot.” And with no federal AI guidelines on the books, states create their own. That’s coming up on today’s episode of Gist Healthcare Daily.
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The FDA approves the first nasal spray formulation to treat anaphylaxis. A report finds that U.S. not-for-profit healthcare providers’ days cash on hand hit a 10-year low. And all eligible hospitals in North Carolina opt into the state’s new medical debt relief program. That’s coming up on today’s episode of Gist Healthcare Daily.
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A medical journal retracts three papers on MDMA-assisted psychotherapy following the FDA’s rejection of the treatment. CMS outlines updates for its ACO REACH model for 2025. And the DOJ finalizes a rule to improve access to medical care for people with disabilities. That’s coming up on today’s episode of Gist Healthcare Daily.
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A federal judge dismisses a lawsuit over the Medicare drug price negotiation program. Provisional data show that COVID has dropped to the 10th leading cause of death in the U.S. And a recent poll finds that fewer Americans view childhood vaccinations as “important.” That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS finalizes a policy that creates a faster pathway to reimbursement for “breakthrough” medical devices. The FDA approves Purdue Pharma’s opioid overdose-reversal device. And a recent report finds that untreated vision loss and high cholesterol could be risk factors for dementia. That’s coming up on today’s episode of Gist Healthcare Daily.
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Providers receive a win in the latest appeals court ruling on the No Surprises Act. About 700 rural hospitals are at risk of closing, according to a new report. And a recent survey finds that less than half of Americans trust doctors. That’s coming up on today’s episode of Gist Healthcare Daily.
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Tenet Healthcare plans to sell its majority stake in five Alabama hospitals. The FDA now lists Eli Lilly’s blockbuster GLP-1 drugs as “available.” And a new study finds that less than half of patients challenge insurance claim denials. That’s coming up on today’s episode of Gist Healthcare Daily.
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CVS is co-locating Oak Street clinics at existing pharmacies. A new Epic feature allows patients to release their medical records to apps of their choice. And a recent study finds that Gen Xers and millennials are more likely to develop certain cancers. That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS finalizes a 2.9 percent Medicare pay bump for inpatient hospital care in 2025. Google is not renewing its contract with Amazon’s One Medical. And more states pass legislation to limit hospitals and provider organizations’ liability following cyberattacks. That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS finalizes four payment rules for 2025, including for skilled nursing and inpatient rehab facilities. A cyberattack strikes a Florida blood bank that serves more than 350 hospitals. And two health system merger deals cross the finish line. That’s coming up on today’s episode of Gist Healthcare Daily.
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Community Health Systems plans to sell its three Pennsylvania hospitals to WoodBridge Healthcare. Walmart will open 25 new pharmacies focused on autoimmune diseases. And CMS green lights North Carolina’s medical debt relief plan. That’s coming up on today’s episode of Gist Healthcare Daily.
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Massachusetts commits $30 million dollars to keep Steward hospitals in the state operating. A new study finds that a double mastectomy did not improve survival for patients with unilateral breast cancer. And healthcare once again lands at top of an annual report on the cost of data breaches. That’s coming up on today’s episode of Gist Healthcare Daily.
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Guardant Health’s blood screening test for colorectal cancer receives federal approval. The FDA warns about dosing errors tied to compounded versions of GLP-1 drugs. And a new study shows that a blood test can accurately diagnose Alzheimer’s disease. That’s coming up on today’s episode of Gist Healthcare Daily.
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A Senate committee votes to both investigate Steward Health Care and subpoena its CEO to testify. The American Medical Association and other physician groups implore Congress to act on physician Medicare pay. And the Health and Human Services Department reorganizes its technology functions to better address AI and cyber threats in healthcare. That’s coming up on today’s episode of Gist Healthcare Daily.
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Ascension sells 9 Illinois hospitals to Prime Healthcare. New analysis shows that Medicare Advantage accounts for a growing percentage of hospital inpatient care. And a study finds that more new GLP-1 prescriptions were written for people with obesity than for those with Type 2 diabetes in recent years. That’s coming up on today’s episode of Gist Healthcare Daily.
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A federal judge refuses to block the FTC’s noncompete ban, deviating from a separate ruling on the ban earlier this month. Humana announces it will take over 23 former Walmart Health sites. And Steward Health Care finds buyers for some of its hospitals, but fails to drum up any qualified bidders for others. That’s coming up on today’s episode of Gist Healthcare Daily.
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A House committee investigation finds PBMs steer patients toward pricier drugs ahead of a Congressional hearing on the issue. A pharmacy group and dozens of providers sue Change Healthcare. And CMS sets limits on ACA marketplace brokers to rein in unauthorized changes to beneficiaries’ plans. That’s coming up on today’s episode of Gist Healthcare Daily.
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A global tech outage highlights vulnerabilities across the U.S. economy, including in healthcare delivery. U.S. health officials are investigating a deadly listeria outbreak tied to deli meat. And Vermont becomes the latest state to sue PBMs over allegations of driving up prescription drug prices. That’s coming up on today’s episode of Gist Healthcare Daily.
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Ardent Health goes public... raising around $192 million dollars in its IPO. A summer COVID wave spreads across the US. And more states look to curb prescription drug costs with public affordability boards. That’s coming up on today’s episode of Gist Healthcare Daily.
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The FDA plans to launch a rare disease center to streamline its policies and methods for evaluating experimental drugs. Drugmaker Roche sees positive results from an early-stage trial of its obesity pill. And a new study finds that bone marrow transplant patients may not need a perfect donor match. That’s coming up on today’s episode of Gist Healthcare Daily.
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Steward Health Care confirms it is under federal investigation. A judge denies an extension for Georgia’s new Medicaid plan, the only in the nation with a work requirement. And new CDC data finds that Americans with disabilities are more likely to report long COVID symptoms. That’s coming up on today’s episode of Gist Healthcare Daily.
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The House Appropriations Committee is requesting that the FDA holds off on regulating laboratory developed tests. A recent report finds that private equity-backed providers account for less than 4 percent of the U.S. provider market by revenue. And a new study links semaglutide to lower risk for both dementia and nicotine use. That’s coming up on today’s episode of Gist Healthcare Daily.
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In its first No Surprises audit, CMS finds some noncompliance with CVS-owned Aetna. State attorneys general warn of consumer impacts from the Change Healthcare cyberattack. And a report says about 7 percent of U.S. adults have had long COVID. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Senate unanimously passes a bill that cracks down on drug patent practices. House GOP leaders demand regulatory reviews from federal agencies, including the Health and Human Services Department, following the Supreme Court’s Chevron decision. And a new study links alcohol to more than a half dozen cancers. That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS proposes a nearly 3 percent Medicare physician pay cut in 2025. The Office of the National Coordinator for Health Information Technology releases its proposed rule to improve data sharing. And a new observational study compares weight loss between adults on tirzepatide versus semaglutide. That’s coming up on today’s episode of Gist Healthcare Daily.
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Sanford Health and Marshfield Clinic Health System are exploring a combination. Medicare proposes a 2.6 percent pay increase for hospital outpatient departments and ambulatory surgical centers. And dozens of Medicare Advantage plans get higher star ratings after CMS recalculations. That’s coming up on today’s episode of Gist Healthcare Daily.
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An interim FTC report scrutinizes pharmacy benefit managers. A proposed federal cybersecurity rule draws criticism from the healthcare industry. And dozens of health systems see their credit ratings drop. That’s coming up on today’s episode of Gist Healthcare Daily.
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In two separate rulings, federal judges partially block both the FTC’s noncompete ban and a federal gender nondiscrimination rule. Massachusetts lawmakers target real estate investment trusts in a sweeping healthcare bill. And the FDA approves Eli Lilly’s early Alzheimer’s treatment. That’s coming up on today’s episode of Gist Healthcare Daily.
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How the U.S. Supreme Court’s Chevron ruling could impact healthcare. Two decades on, the U.S. has made little progress on addressing health inequities... according to a new report. And HHS and the FBI warn the healthcare sector of certain types of cyberattacks, including phishing schemes. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Congressional Budget Office projects that the nation’s uninsured rate will rise to nearly 9 percent by 2034. More nurse practitioners are moving into specialty care. And early results from a large clinical trial show a new drug may provide total protection against HIV. That’s coming up on today’s episode of Gist Healthcare Daily.
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The UAB Health System Authority signs an agreement to acquire Ascension St. Vincent. Missouri joins a growing list of states passing laws to expand 340B drug access. And Teva Pharmaceuticals launches first generic GLP-1 drug in the U.S. That’s coming up on today’s episode of Gist Healthcare Daily.
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The U.S. Surgeon General declares gun violence a public health crisis. The U.S. Supreme Court agrees to hear a case challenging Tennessee’s ban on gender-affirming care for minors. And HHS finalizes a rule that sets penalties for providers blocking the free exchange of electronic health record data. That’s coming up on today’s episode of Gist Healthcare Daily.
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A federal appeals court largely upholds the ACA’s free preventive services mandate. A new study finds that a popular GLP-1 drug may help treat sleep apnea.
And more states are expanding Medicaid coverage to hospital at home care. That’s coming up on today’s episode of Gist Healthcare Daily.
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Risant Health announces its plan to acquire Cone Health. The WHO warns about fake versions of the diabetes drug Ozempic. And federal actuaries project that U.S. healthcare spending will hit nearly $8 trillion by 2032. That’s coming up on today’s episode of Gist Healthcare Daily.
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The U.S. Supreme Court rejects a case challenging the FDA’s policies on mifepristone. Ascension says protected health data might have been exposed in its recent cyberattack. And the director of CMS’ Innovation Center testifies before a Congressional subcommittee. That’s coming up on today’s episode of Gist Healthcare Daily.
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The White House teams up with Big Tech to help boost rural hospital cybersecurity. Insurers get another court win with a recent Medicare Advantage star ratings ruling. And Walgreens-owned CityMD agrees to pay $12 million for alleged COVID payment fraud. That’s coming up on today’s episode of Gist Healthcare Daily.
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FDA advisors unanimously recommend approval of Eli Lilly’s Alzheimer’s drug donanemab. The Biden administration proposes a rule to ban medical debt from consumer credit reports. And the U.S. Supreme Court will review a case on Medicare Disproportionate Share Hospital payments. That’s coming up on today’s episode of Gist Healthcare Daily.
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Moderna reports positive results from its COVID-flu combined vaccine late-stage trial. A new Florida law allows doctors to perform c-sections outside of hospitals. And the American Cancer Society aims to enroll 100,000 Black women in an ambitious new cancer study. That’s coming up on today’s episode of Gist Healthcare Daily.
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Kroger Health expands its weight-management program to include GLP-1 treatments. Cases of whooping cough more than double in the U.S. And new research links 200-plus symptoms to long COVID. That’s coming up on today’s episode of Gist Healthcare Daily.
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Oregon Health & Science University and Legacy Health sign an agreement to merge. A judge rejects an FTC request to block Novant Health’s acquisition of two CHS hospitals. And a group of Senators introduce legislation to overturn the nursing home staffing mandate. That’s coming up on today’s episode of Gist Healthcare Daily.
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An FDA advisory panel recommended against using ecstasy as a treatment for PTSD. A Congressional subcommittee weighs reforming the 340B Drug Pricing Program. And a new study reports that drug shortages are more frequent and last longer. That’s coming up on today’s episode of Gist Healthcare Daily.
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SCAN Health Plan wins its Medicare Advantage star ratings lawsuit against CMS. The University of Pittsburgh Medical Center acquires Washington Health System. And a new study highlights racial and ethnic disparities within Medicaid renewal procedural issues. That’s coming up on today’s episode of Gist Healthcare Daily.
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HHS clarifies that Change Healthcare is responsible for data breach notifications – not individual providers. Structure Therapeutics reports that its oral GLP-1 drug led to weight loss in two small studies. And the FDA approves Moderna’s mRNA RSV vaccine for adults over 60. That’s coming up on today’s episode of Gist Healthcare Daily.
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Novartis sues to block a Maryland law concerning contract pharmacies and the 340B drug pricing program. Hospitals find fault with CMS’ proposed Transforming Episode Accountability Model. And a new study examines the impact of cyberattacks on nearby unattacked hospitals. That’s coming up on today’s episode of Gist Healthcare Daily.
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Dollar General and Doc-Go halt their mobile health clinic program. The American Clinical Laboratory Association sues over the FDA’s final rule regulating laboratory-developed tests. And a new report says NIH-funded clinical trials often don't meet their racial & gender diversity enrollment goals. That’s coming up on today’s episode of Gist Healthcare Daily.
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Hospital groups join a multi-sector plea to the FTC to delay a new ban on noncompetes. A new study ties weight-loss drug Wegovy to reduced risk for alcohol use disorder. And drugmaker Eli Lilly says it will spend billions of dollars to expand its GLP-1 production capacity. That’s coming up on today’s episode of Gist Healthcare Daily.
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Recent congressional hearings zero in on healthcare consolidation. Nursing home trade groups sue over the Biden Administration’s new staffing mandate. And a new CDC analysis shows that stroke rates have been on the rise. That’s coming up on today’s episode of Gist Healthcare Daily.
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Novo Nordisk reports that its GLP-1 drug Ozempic could help treat kidney disease. An advisory panel recommends the FDA approve Guardant Health’s colon cancer blood test. And Louisiana lawmakers vote to reclassify abortion pills as controlled dangerous substances. That’s coming up on today’s episode of Gist Healthcare Daily.
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Another human bird flu case linked to dairy cows is reported in Michigan. Drugmakers win a court victory amid the legal battle over the 340-B Drug Pricing Program. And Los Angeles County launches a new plan for tackling medical debt. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Senate Judiciary Committee accuses drugmakers of abusing the patent system, causing prescription drug prices to soar. Patients denied emergency care can now file complaints directly to the Centers for Medicare and Medicaid Services. And a new study reports that many Americans are quitting weight-loss drugs before their health benefits kick in. That’s coming up on today’s episode of Gist Healthcare Daily.
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An Health and Human Services agency announces a new cybersecurity protection program for hospitals. The Senate Finance Committee weighs in on Medicare physician payment reform. And UnitedHealth’s pharmacy benefit manager announces a new drug pricing model. That’s coming up on today’s episode of Gist Healthcare Daily.
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A federal transparency rule on direct-to-consumer prescription drug advertising takes effect. Telehealth company Hims & Hers Health announced it will offer compounded GLP-1 medications. And the Centers for Disease Control and Preventions ends its free COVID vaccine program for the under and uninsured this summer. That’s coming up on today’s episode of Gist Healthcare Daily.
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The U.S. Justice Department starts the formal process to reclassify marijuana as a less dangerous drug. The CDC warns about a possible resurgence of m-pox. And the number of hospital-at-home programs is increasing, even as the future of Medicare reimbursement remains uncertain. That’s coming up on today’s episode of Gist Healthcare Daily.
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The FDA approves self-collection screening for HPV. Eli Lilly reports promising results for its weekly insulin drug. And the country’s only tribal-affiliated medical school graduates its first class of physicians. That’s coming up on today’s episode of Gist Healthcare Daily.
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Jefferson Health and Lehigh Valley Health Network sign an agreement to merge. Preliminary data shows a drop in overdose deaths in 2023. Marking the first decline in years. And Novo Nordisk will test whether its weight-loss drugs can help people with alcohol-related liver disease. That’s coming up on today’s episode of Gist Healthcare Daily.
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A federal judge partially dismisses a lawsuit accusing a private equity firm of suppressing competition in the anesthesia market. New analyses of clinical trial results show Wegovy users kept weight off for years. And U.S. News and World Report puts out its first ambulatory surgery center ratings. That’s coming up on today’s episode of Gist Healthcare Daily.
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Ascension confirms its ongoing cyber event was a ransomware attack. CMS extends Medicaid unwinding waivers for states into 2025. And MultiPlan faces another lawsuit accusing it of colluding with insurers on provider reimbursement rates. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Biden Administration is planning to issue cybersecurity standards for hospitals. The DOJ forms a new task force focused on anti-competitive behavior in healthcare. And a new survey shows most Americans want Medicare to cover weight-loss drugs. That’s coming up on today’s episode of Gist Healthcare Daily.
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Nonprofit health system Ascension reports a cyber incident. A U.S. House committee advances a bill extending telehealth and hospital-at-home care. And CMS proposes a new mandatory model for kidney transplants. That’s coming up on today’s episode of Gist Healthcare Daily.
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Steward Health Care puts its hospitals up for sale after its bankruptcy filing. The human risk for bird flu remains low in the US. But 2 human infections raise questions about pandemic readiness. And the Biden Administration faces a lawsuit over a rule barring gender identity discrimination in healthcare. That’s coming up on today’s episode of Gist Healthcare Daily.
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Walgreens will partner with a major drugmaker on a GLP-1 clinical trial. Oregon is helping Medicaid patients prepare for the health impacts of climate change. And new long-acting HIV therapies could change prevention and treatment. That’s coming up on today’s episode of Gist Healthcare Daily.
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Hospital operator Steward Health Care files for Chapter 11 bankruptcy. An effort to expand Medicaid in Mississippi collapses. And MultiPlan faces mounting legal troubles and potential federal scrutiny over allegations of health care price fixing. That’s coming up on today’s episode of Gist Healthcare Daily.
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HHS expands access to the ACA health insurance market to Dreamers lacking coverage. Pregnancy-related deaths are on the decline. But some physicians still have concerns. And data shows that community health centers are taking a hit from the Medicaid redetermination process. That’s coming up on today’s episode of Gist Healthcare Daily.
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The HHS Office for Civil Rights updates a disability rights rule. UnitedHealthcare and Walmart are ending their shared Medicare Advantage plan. And a federal judge rules against drugmakers in their Medicare drug price negotiation challenge. That’s coming up on today’s episode of Gist Healthcare Daily.
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UnitedHealth Group’s CEO testifies before Congress about the Change Healthcare cyberattack. An expert panel issues new recommendations for breast cancer screenings. And a federal judge rules that state health plans must cover gender-affirming care. That’s coming up on today’s episode of Gist Healthcare Daily.
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Walmart is closing all of its health centers... as well as its virtual care platform. The Food and Drug Administration moves to regulate laboratory developed tests.
And hospitals no longer have to report COVID-19 data to the federal government. That’s coming up on today’s episode of Gist Healthcare Daily.
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The White House puts a menthol cigarette ban on the back burner. The U.S. Department of Health and Human Services issues a final rule strengthening the Affordable Care Act’s sex discrimination protections. And the Federal Trade Commission restricts digital health apps’ sharing of personal data. That’s coming up on today’s episode of Gist Healthcare Daily.
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A Senate committee is investigating the cost of popular diabetes and weight-loss drugs. Kaiser Permanente reports a data breach that impacts more than 13 million people. And a new study examines why nurses are calling it quits on healthcare jobs. That’s coming up on today’s episode of Gist Healthcare Daily.
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The U.S. Supreme Court seemed split after oral arguments in a case involving the Emergency Medical Treatment and Labor Act. The FTC said it will consider cybersecurity when evaluating potential mergers. And Walgreens announced a new $24-billion specialty pharmacy business. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Federal Trade Commission announced a final rule banning noncompetes nationwide. CMS issued a rule finalizing staffing minimums for nursing homes. And a recent Congressional Budget Office report digs into Medicare ACO cost savings. That’s coming up on today’s episode of Gist Healthcare Daily.
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United-Health Group confirms it paid a ransom following the Change Healthcare cyberattack. CMS finalizes a Medicaid rule to improve access to home-based care and increase transparency. And a CDC report examines barriers patients face in getting mammograms. That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS proposes a first-of-its-kind initiative addressing greenhouse gas emissions from hospitals. A new study analyzes telehealth’s impact on quality of care and spending. And cancer-detecting blood tests are gaining momentum. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Biden Administration released a final rule on the 340B Drug Pricing Program administrative dispute resolution process. The federal government has created a healthcare anti-trust reporting portal for the public. And a major cancer institute has retracted several research studies. That’s coming up on today’s episode of Gist Healthcare Daily.
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Trials show promising results that weight-loss drug Zepbound also helps with sleep apnea. Physician assistants get an initial win in a job title rebrand. And racial health disparities continue to be an issue in every state. That’s coming up on today’s episode of Gist Healthcare Daily.
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Insurer Elevance Health partners with a private equity firm to launch a new primary care company. Telehealth startup Cerebral is under a federal order to limit its use of sharing sensitive customer health data. And Indiana joins a growing list of states with laws requiring advance notice of healthcare transactions. That’s coming up on today’s episode of Gist Healthcare Daily.
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Hackers begin leaking Change Healthcare data as Congress prepares for hearings on the cyberattack. More prior authorization changes could be on the way.
And CVS plans to open Oak Street Health clinics at its retail pharmacy stores. That’s coming up on today’s episode of Gist Healthcare Daily.
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A quarter of adults dropped from Medicaid report now being uninsured. Drug shortages in the U.S. hit an all-time high. And a study questions fast-tracking federal approval of cancer drugs. That’s coming up on today’s episode of Gist Healthcare Daily.
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Medicare anticipates spending billions on a new Alzheimer drug. A new study examines the effects of medical debt relief. And gender and race disparities continue to impact heart transplant acceptance rates. That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS proposes a modest increase to inpatient payments for fiscal year 2025. Walgreens-backed VillageMD has a new president. And cancer cases are on the rise among young people. But why? That’s coming up on today’s episode of Gist Healthcare Daily.
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Physicians report significant financial impacts from the Change Healthcare cyberattack. A new trail challenges whether beta blockers help all heart attack patients. And the FDA comes under scrutiny for its clinical research oversight protocols. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Biden Administration has issued a final rule further regulating Medicare Advantage marketers. The U.S. Senate is escalating its probe into the effects of private equity investments in healthcare. And Change Healthcare is looking to consolidate the lawsuits it's facing over its handling of February’s cyberattack. That’s coming up on today’s episode of Gist Healthcare Daily.
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In March 2023, employee healthcare navigation company Transcarent announced it would acquire AI-powered primary care startup 98point6’s virtual care platform and care business. On today’s encore episode of Gist Healthcare Daily, we hear the second part of host J. Carlisle Larsen’s conversation with Transcarent CEO Glen Tullman about that acquisition and how it fits into his company’s long-term goals. They also discuss Tullman’s thoughts on the future of employer-sponsored healthcare.
This conversation originally aired on December 4, 2023
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Employee healthcare navigation company Transcarent announced in September 2023 that it had partnered with an inaugural group of 10 large health systems to create what it calls a national, independent “provider ecosystem” in order to provide higher-quality care to the covered beneficiaries of its more than 300 employer clients. On today’s episode of Gist Healthcare Daily, we revisit host J. Carlisle Larsen’s conversation with Transcarent CEO Glen Tullman where they discussed the health system partnerships and the company’s direct contracting model.
This conversation first aired on November 27, 2023
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The Biden Administration establishes ACA adequacy standards and aligns annual open enrollment periods for state-based exchanges. Walmart Health is reportedly slowing down its 2024 health center expansion plan. And, telehealth providers call on the Drug Enforcement Administration to release a final rule on the virtual prescribing of controlled substances. That’s coming up on today’s episode of Gist Healthcare Daily.
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Kaiser Permanente’s Risant Health finalizes its acquisition of Pennsylvania-based health system Geisinger. Intermountain-owned Saltzer Health shuts down operations and sells clinics. And, the Biden Administration finalizes its Medicare Advantage pay rate for 2025. That’s coming up on today’s episode of Gist Healthcare Daily.
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During the COVID-19 pandemic, the federal government implemented a rule that prevented states from removing people from Medicaid. But following the end of the public health emergency at the end of March 2023, states began the eligibility redetermination process. Since then, more than 19 million people have lost their Medicaid or CHIP coverage.
Jennifer Wagner, Director of Medicaid Eligibility and Enrollment at the Center on Budget and Policy Priorities, joins the podcast to talk more about what we’ve seen over the last year and what it could mean for future Medicaid policies.
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The Biden Administration streamlines the renewal and enrollment process for Medicaid and CHIP beneficiaries. Walgreens will close more VillageMD clinics in the coming weeks, as it reports a nearly 6-billion dollar net loss in its second fiscal quarter. And, capping the cost of insulin lowered consumers’ out of pocket expenses but didn’t result in greater access to the drug, according to a new study. That’s coming up on today’s episode of Gist Healthcare Daily.
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Optum will acquire the financially troubled Steward Health’s national physician group. The Supreme Court signals skepticism over arguments made challenging the FDA’s approval of a key drug used in medication abortions. And, Change Healthcare says its largest clearing house is operational after a February cyber attack. That’s coming up on today’s episode of Gist Healthcare Daily.
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Congress unveils its $1.2 trillion spending bill with funding for the Department of Health and Human Services. New reports highlight errors with the Department of Veterans’ Affairs and Oracle’s deployment of its electronic health record system. And, a new study finds that a majority of new physicians have faced sexual harassment. That’s coming up on today’s episode of Gist Healthcare Daily.
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Early last October, Providence Health unveiled Praia Health, its fourth, incubated technology. Praia utilizes what the Digital Innovation Group calls a digital flywheel to keep patients engaged with their care by personalizing individuals' health journeys and seamlessly connecting them t o the right services, products and resources.
On today’s episode, we hear the second half of JC’s conversation with Sara Vaezy, Executive Vice President and Chief Strategy and Digital Officer for Providence, where they talk more about Praia’s value proposition to hospitals and the future of the health system’s digital strategy.
This conversation originally aired on October 16, 2023
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In October, Renton, Washington-based health system Providence unveiled Praia Health, its latest incubated technology. Praia is a platform-as-a-service developed for health systems to increase patient engagement by personalizing individuals' health journeys and seamlessly connecting them to the right services, products and resources.
On today’s episode of Gist Healthcare Daily, we revisit host J. Carlisle Larsen’s conversation with Sara Vaezy, Executive Vice President and Chief Strategy and Digital Officer for Providence. She joined the podcast to talk more about Praia Health, including its goals and the issues it aims to address.
This conversation originally aired on October 9, 2023
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Lawmakers press the Department of Health and Human Services over its response to the Change Healthcare cyberattack. Medicare Part D plans can cover the popular–and expensive–weight loss drug Wegovy for beneficiaries with heart conditions. And, VillageMD sells 11 clinics in Rhode Island to Arches Medical Partners. That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS launches a new model that aims to increase primary care participation in Medicare ACOs. The U.S. Senate releases a military report flagging risks in the nation’s drug supply chain. And, the CDC releases new guidance for hospital CEOs to mitigate burnout in the healthcare workforce. That’s coming up on today’s episode of Gist Healthcare Daily.
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National supermarket chain Kroger plans to sell its specialty pharmacy business to Elevance Health. The Centers for Disease Control and Prevention issues a new health alert as measles cases continue to climb. And, the number of abortions nationwide increased in the first year following the overturning of Roe v. Wade, according to a new report. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Centers for Medicare and Medicaid Services extends Medicaid payment flexibilities amid the ongoing Change Healthcare outage. President Biden signs an executive order to expand research on women’s health. And, another drugmaker caps prescription asthma inhaler prices at $35 per month amid lawmaker scrutiny. That’s coming up on today’s episode of Gist Healthcare Daily.
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Ongoing healthcare workforce shortages have prompted hospitals and health systems to expand educational and internship programs to better engage young people in pursuing careers in healthcare. For the past two weeks, Gist Healthcare Daily has highlighted initiatives underway at University Hospitals in Cleveland, Ohio to attract high school students to the healthcare industry. Today, host J. Carlisle Larsen speaks with Zach Fleitman, founder and CEO of Workup Health, to learn more about how the talent pipeline management platform works with health systems– including University Hospitals– to help them track and evaluate the impact of their youth outreach programs.
You can find JC’s two-part conversation with Celina Cunanan of University Hospitals at the links below:
How University Hospitals in Cleveland Engages with Youth in its Communities to Build its Talent Pipeline (March 4, 2024)
Continuing the Conversation: Celina Cunanan of University Hospital about the importance of talent pipeline development, diversifying the provider workforce (March 12, 2024)
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The federal government will investigate UnitedHealth Group following the Change Healthcare cyber attack. Diabetes and weight loss drug Ozempic was found to delay the progression of chronic kidney disease in diabetic patients, according to a large-scale clinical trial. And, drugmaker Eli Lilly partners with Amazon to deliver its weight loss drug Zepbound, directly to consumers’ homes. That’s coming up on today’s episode of Gist Healthcare Daily.
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A U.S. Circuit Court rules against a pharmaceutical lobbying group in the ongoing fight over 340B drug discounts. Corvallis Clinic asks Oregon for an exemption from the state’s oversight process to merge with Optum. And, the healthcare industry remains the top target for cyber criminals. That’s coming up on today’s episode of Gist Healthcare Daily.
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Federal officials offer emergency funding to providers as the Change Healthcare outage stretches into its fourth week. President Biden releases his proposed 2025 budget, which includes some big ticket healthcare items. And, the Food and Drug Administration says that the weight loss drug Wegovy can be prescribed for heart problems. That’s coming up on today’s episode of Gist Healthcare Daily.
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For three years in a row, workforce and personnel issues remain the top concern for healthcare leaders across the country, according to a recent survey published by the American College of Healthcare Executives.
On today’s episode of Gist Healthcare Daily, we listen to the second half of host J. Carlisle Larsen’s conversation with Celina Cunanan, Chief Diversity, Equity & Belonging Officer at Cleveland, Ohio-based University Hospitals, about how diversifying University Hospitals’ talent pipeline–and by extension, its workforce–benefits both the system and the community as a whole.
You can listen to the first half of their conversation here.
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President Biden calls for expanding the number of drugs Medicare can negotiate prices on. Cigna strikes a deal with drugmakers to cap the cost of popular obesity medications for employer-sponsored health plans. And, Mark Cuban’s Cost Plus Drugs inks its first health system partnership. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Centers for Medicare and Medicaid Services announces provider flexibilities in the wake of the ongoing challenges associated with the recent Change Healthcare cyber attack. The White House announces a new federal task force to investigate healthcare costs. And, Opill–the first over-the-counter birth control pill–will hit shelves later this month. That’s coming up on today’s episode of Gist Healthcare Daily.
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The nation’s two largest retail pharmacy chains will begin dispensing the drug mifepristone, which can be used in a medication abortion. A growing number of physicians are employed by private equity groups, according to a new study. And, a CMS report outlines a drop in quality measure performance at hospitals during the first two years of the pandemic. That’s coming up on today’s episode of Gist Healthcare Daily.
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Change Healthcare opens a backup pharmacy system as outages continue following a cyberattack late last month. Hospitals and physicians may see some relief in a newly proposed federal spending deal. And, the Centers for Disease Control and Prevention drops its five-day isolation guidance for COVID-19 infections. That’s coming up on today’s episode of Gist Healthcare Daily.
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Bloomberg Philanthropies recently announced it would partner with major health systems and invest $250 million dollars to launch healthcare-oriented high schools to address an expected shortage of workers within the industry. But many hospitals and health systems have educational programs today that aim to get young people interested in healthcare careers.
Celina Cunanan, Chief Diversity, Equity & Belonging Officer at University Hospitals in Cleveland, Ohio, joins the podcast to talk more about how her health system engages with young people in its communities as part of its workforce development efforts.
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Northwell Health and Nuvance Health announce plans to merge. VillageMD plans to close all of its clinics in Illinois. And, antidepressant prescribing for young people increased significantly during the COVID-19 pandemic. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Department of Justice launches an antitrust investigation into UnitedHealth Group. Colorado regulators force U.S. Anesthesia Partners to end exclusive contracts at some hospitals in the state. And, hackers are reportedly looking to sell data from a recent breach at a children’s hospital. That’s coming up on today’s episode of Gist Healthcare Daily.
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Measles cases are on the rise in several states across the country. Healthcare settlements tied to the False Claims Act reached $1.8 billion in fiscal year 2023. And, a New York City medical school receives a $1 billion donation to make tuition free for students. That’s coming up on today’s episode of Gist Healthcare Daily.
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Optums says it expects outages related to a cyber attack against Change Healthcare to continue for at least another day. Colorado becomes the first state in the nation to set a drug price ceiling. And, nearly 40 state Attorneys General are asking Congressional lawmakers for federal legislation to regulate pharmacy benefit managers. That’s coming up on today’s episode of Gist Healthcare Daily.
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Data sharing platform Health Gorilla surveyed more than 1,200 consumers to gauge their opinion about the privacy of their health data and which companies should be allowed to access it. It found a vast majority of respondents expressed concerns about data breaches affecting their medical records. Steven Lane, MD, Chief Medical Officer for Health Gorilla, joins the podcast to talk more about the survey, patient privacy, and the role of interoperability.
You can find Health Gorilla’s State of Patient Privacy report here.
This episode originally aired on September 5, 2023
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Walgreens plans to shutter all of its VillageMD locations in Florida amid ongoing cost-cutting measures. Mississippi considers a Medicaid expansion…but with job requirements. And, a cyber security attack disrupts UnitedHealth’s Change Healthcare operations. That’s coming up on today’s episode of Gist Healthcare Daily.
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Medicare Advantage enrollment is up as payers worry about higher MA costs. The Centers for Medicare and Medicaid Services finalizes a rule for Medicaid disproportionate share hospital payments. And, nearly half of newborns in the United States received protection against respiratory syncytial virus.That’s coming up on today’s episode of Gist Healthcare Daily.
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The Biden Administration launches a probe into how the business practices of hospital purchasing groups and drug distributors may impact shortages of drugs. The number of surprise billing disputes heading to arbitration remains well beyond original federal estimates, according to new data. And, a popular vitamin may increase the risk of cardiovascular disease. That’s coming up on today’s episode of Gist Healthcare Daily.
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A recent Washington Post article found that seven companies allegedly submitted around $2 billion in fraudulent claims to Medicare for intermittent urinary catheters that were not ordered, wanted, or received by patients. On today’s episode of Gist Healthcare Daily, Washington Post national health reporter Dan Diamond speaks with host J. Carlisle Larsen about the story.
You can read the Washington Post article here.
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Nonprofit health insurers SCAN Health and CareOregon call off their proposed merger. Federal lawmakers are reportedly considering a slight Medicare pay increase for physicians. And, a new report outlines the states with the biggest share of adults with medical debt. That’s coming up on today’s episode of Gist Healthcare Daily.
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A federal judge throws out a lawsuit challenging Medicare’s drug price negotiation process. The CDC is expected to change its isolation guidelines for COVID-19 infections. And, employer-focused primary care providers Marathon Health and Everside Health plan to merge. That’s coming up on today’s episode of Gist Healthcare Daily.
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The University of Minnesota strikes a deal with Fairview Health Services to buy back its flagship academic medical center, after selling it more than 25 years ago. The Biden Administration wants more oversight of healthcare accrediting organizations. And, a new study finds that popular weight loss drugs may improve some mental health conditions. That’s coming up on today’s episode of Gist Healthcare Daily.
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Healthcare M&A activity was up in 2023 following a decline during the COVID-19 pandemic, according to a new report from Kaufman Hall.
Last Monday, Anu Singh, Managing Director and Leader of the Partnerships, Mergers & Acquisitions Practice at Kaufman Hall, spoke with host J. Carlisle Larsen about how financial distress was the main driver of many of the smaller-to-medium sized hospital deals last year.
In the second half of their conversation, they discuss how more financially stable health systems are considering less traditional, strategic M&A deals and what kinds of conversations are happening right now in C-suites.
You can listen to the first part of our conversation here.
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The leaders of three major pharmaceutical companies testified on Capitol Hill this week about the high cost of prescription drugs. The Biden Administration outlines how Medicare Advantage insurers can use AI. And, Walgreens taps a new executive to lead its healthcare business. That’s coming up on today’s episode of Gist Healthcare Daily.
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A House panel passes a key PBM reform for health insurance for federal employees. Amazon will lay off hundreds of employees across its healthcare division. And, healthcare jobs grew at the fastest rate since the early 1990s. That’s coming up on today’s episode of Gist Healthcare Daily.
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Optum plans to purchase Oregon-based multi-specialty medical group The Corvallis Clinic. Medicaid’s net enrollment is down by about 10 million midway through the continuous enrollment unwinding process. And, Walgreens partners with pharmacy schools to address workforce shortages. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Biden Administration finalizes telehealth flexibilities for opioid treatment programs. Novo Nordisk’s parent company will buy a US-based facility reportedly to ramp up production of its blockbuster weight loss drugs. And senior-oriented primary care provider Cano Health files for bankruptcy. That’s coming up on today’s episode of Gist Healthcare Daily.
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There were 65 hospital and health system M&A deals announced last year, an increase from 53 in 2022. The rise reflects a growing momentum following a pandemic-related slow down, according to a recent report from Kaufman Hall.
Anu Singh, Managing Director and Leader of the Partnerships, Mergers & Acquisitions Practice, joins the podcast to talk more about how financial distress was a driving factor in smaller deals, as well as how other systems looked for more strategic partnerships.
Upcoming webinar: Navigating Strategic Options in a Transformed Operating Environment. (February 26, 2024 at 2:00pm-CT) Register here.
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Biogen will stop selling its Alzheimer’s drug, Aduhelm, amid controversy. The Biden Administration makes its initial offers to drug companies on the first ten drugs to be negotiated through Medicare, as courts weigh lawsuits brought by pharmaceutical companies challenging the negotiation process. And, participation in Medicare accountable care organizations is up. That’s coming up on today’s episode of Gist Healthcare Daily.
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Cigna officially offloads its Medicare Advantage business to Health Care Service Corporation. The Biden Administration will negotiate on behalf of states to provide a groundbreaking gene therapy for Medicaid beneficiaries with sickle cell disease. And, the Dana Farber Cancer Institute is issuing corrections and retracting some research papers amid falsification allegations. That’s coming up on today’s episode of Gist Healthcare Daily.
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Fitch Ratings says lower operating margins at nonprofit hospitals may be here to stay. The Biden Administration wants stakeholder input on making Medicare Advantage more transparent. And, a new study examines a small number of transmissible Alzheimer’s cases tied to a medical treatment that’s no longer used. That’s coming up on today’s episode of Gist Healthcare Daily.
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Federal regulators sue to block Novant Health’s purchase of two Community Health Systems hospitals in North Carolina. Insurers say that the No Surprises Act prevented 10 million surprise bills for patients in the first nine months of 2023. And, North Carolina says it will no longer pay for popular–and costly–weight loss drugs for state employees. That’s coming up on today’s episode of Gist Healthcare Daily.
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Congressional lawmakers established a new arbitration process when they passed the No Surprises Act in December 2020. Since April 2022, payers and providers have been able to have a third-party settle payment disputes over out-of-network claims. However, the process has been bogged down by exceedingly high caseloads and legal challenges.
On today’s episode of Gist Healthcare Daily, Matthew Fiedler, Senior Fellow at the Brookings Institution, joins the podcast to talk more about how the process has fared overall since its launch.
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The Biden Administration releases voluntary cybersecurity goals for healthcare providers. It was a record-breaking year for health plan enrollment on the Affordable Care Act exchanges. And, a majority of rural hospitals have had to cut labor and delivery services for pregnant people. That’s coming up on today’s episode of Gist Healthcare Daily.
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Walgreens is reportedly exploring a sale of its specialty pharmacy business, Shields Health. Instacart expands its reach into the home care sector. And, the mortality rate among hospital-at-home patients is low, according to a recent study. That’s coming up on today’s episode of Gist Healthcare Daily.
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Bloomberg Philanthropies will invest $250 million to launch healthcare-focused high schools to address workforce shortages. Younger people are being diagnosed with cancer at higher rates, according to recent studies. And, funding for digital health projects is at its lowest point since 2019. That’s coming up on today’s episode of Gist Healthcare Daily.
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Intermountain’s Saltzer Health faces a shutdown if it can’t find a buyer. Physicians at two Allina Health hospitals get the green light to unionize. And, disproportionate share hospitals will continue to receive payments–temporarily–as Congress averts another government shutdown in the short term. That’s coming up on today’s episode of Gist Healthcare Daily.
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Hospitals and health insurers were more compliant with price transparency laws and regulations in 2023, according to healthcare price data company Turquoise Health. Carol Skenes, Principal Strategist at Turquoise, joins the podcast to talk more about what this data means for consumers and the healthcare industry.
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For the last 15 years, ZocDoc has connected physicians and other healthcare professionals to patients seeking care through its tech-enabled online marketplace. On today’s episode of Gist Healthcare Daily, Oliver Kharraz, MD, Founder and CEO of ZocDoc, joins the show to talk about how the company looks at the evolution of patient acquisition.
You can check out ZocDoc’s white paper on patient acquisition here.
This episode first aired on May 8, 2023
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Venture capital firm General Catalyst’s healthcare arm plans to purchase Akron, Ohio-based Summa Health, and turn it into a for-profit system. CMS issues a final rule that aims to streamline health insurer prior authorizations. And, the FDA approves a groundbreaking CRISPR treatment for a second blood disease. That’s coming up on today’s episode of Gist Healthcare Daily.
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Jarrard’s second survey in its “Beyond Burnout” series examines how nurses are feeling overall about their job satisfaction and career calling, as well as the level of trust they have in the organizations and leadership.
On today’s episode of Gist Healthcare Daily, we hear the second part of JC’s conversation with David Jarrard, Executive Chair of Jarrard Inc., where they talk more about how onboarding can make or break nurse retention.
You can find Jarrard's second part of the “Beyond Burnout” survey series here.
You can also find the first part of JC’s conversation with David Jarrard about the nurse survey here.
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A recent survey published by strategic healthcare communications consulting firm Jarrard Inc. finds that job satisfaction among nurses is increasing, with roughly two-thirds saying they plan to stay in the field.
Today, David Jarrard, Executive Chair of Jarrard Inc., joins the podcast to talk more about the survey.
You can find the second part of Jarrard’s “Beyond Burnout” survey series here.
You can also find JC’s conversation with David Jarrard about the firm’s 2023 physician survey here.
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Amazon and digital healthcare company Omada ink a deal focused on treating and preventing chronic conditions. The Department of Health and Human Services announces its new competition chief. And, Affordable Care Act plan enrollment reaches a record high for the 2024 plan year. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Biden Administration replaces an expanded provider conscience rule put in place during the Trump presidency. The Federal Trade Commission has banned a data broker from selling sensitive location information, like physician office visits. And, California becomes the first state to extend Medicaid to all eligible undocumented adults. That’s coming up on today’s episode of Gist Healthcare Daily.
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Senate Democrats launch an investigation into the price of asthma inhalers. Walgreens will pay health insurer Humana $360 million in a drug pricing settlement. And, the American Red Cross raises the alarm over a national blood shortage. That’s coming up on today’s episode of Gist Healthcare Daily.
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Two midwestern health systems call off their proposed merger. The FDA–for the first time–has authorized a state to import some prescription drugs from Canada. And a new study finds that for pediatric cases ChatGPT has a higher error rate. That’s coming up on today’s episode of Gist Healthcare Daily.
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Burnout has been a major concern for healthcare providers for years, with clinicians pointing to administrative work being a chief contributing factor. Now, some organizations are testing new tools powered by artificial intelligence to help assist with that workload.
On today’s episode of Gist Healthcare Daily, Kristine Lee, MD, Associate Executive Director of Virtual Medicine, Technology, and Innovation at The Permanente Medical Group, joins the podcast to share what the 10,000-physician group is seeing from its current pilot of an ambient AI scribe.
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Cigna is reportedly close to finalizing a deal to sell its Medicare Advantage business. Eli Lilly unveils a new program to sell its blockbuster weight loss drugs directly to patients. And, hospitals around the country reinstate mask mandates amid a surge of COVID and other respiratory illnesses. That’s coming up on today’s episode of Gist Healthcare Daily.
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BJC and St. Luke’s finalize their merger, creating a 28-hospital system across three Midwestern states. More Americans will pay less in out-of-pocket costs for insulin this year. And, a new study finds an increase in adverse events at hospitals acquired by private equity firms. That’s coming up on today’s episode of Gist Healthcare Daily.
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Hospitals and health systems have long grappled with high contingent labor costs, and that issue was put into stark relief during the COVID-19 pandemic. In this encore episode, Jeff Niles, Executive Vice President of Healthcare Workforce Logistics, joins the podcast to talk more about how the company works with systems to establish private label, vendor-neutral contingent workforce solutions to bring down costs and increase fill rates.
This episode originally aired on May 22, 2023
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Federal antitrust regulators finalize new merger guidelines that will have a significant impact on healthcare dealmaking. An independent Iowa pharmacy files a lawsuit against UnitedHealth and OptumRx alleging high back-end fees. And, we’re seeing a rise in respiratory illnesses–and a new COVID variant–ahead of the holidays. That’s coming up on today’s episode of Gist Healthcare Daily.
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Two Pennsylvania-based health systems announce their plan to merge in the new year. New data shows that a majority of children who have lost Medicaid coverage this year came from just nine states. And, preliminary numbers show nearly 19 million people have enrolled in coverage through the ACA exchanges for the 2024 plan year. That’s coming up on today’s episode of Gist Healthcare Daily.
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Elevance Health’s proposed $2.5 billion acquisition of Blue Cross and Blue Shield of Louisiana is back in play. CMS reopens the No Surprises Act dispute portal. And, a new poll shows that Americans are growing more dissatisfied with healthcare. That’s coming up on today’s episode of Gist Healthcare Daily.
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On today’s episode of Gist Healthcare Daily, we hear the second part of JC’s conversation with Micky Tripathi, National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services, about proposed penalties for healthcare providers that engage in information blocking and how they fit into the federal government’s overall interoperability goals.
You can find the first part of our conversation here.
You can read HHS’ proposed rule here.
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The Department of Health and Human Services released a set of three proposed monetary penalties for healthcare providers–both organizations and physicians–that engage in so-called information blocking. That practice interferes with, prevents, or discourages access, exchange, or use of electronic health information. It was banned in 2016’s 21st Century Cures Act. Today, Micky Tripathi, head of the Office of the National Coordinator for Health IT (ONC), joins the podcast to talk more about what information blocking looks like among healthcare providers and what the proposed penalties aim to do.
You can read HHS’ proposed rule here. Be sure to tune in for the second part of our conversation tomorrow.
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Healthcare spending reached $4.5 trillion in the United States in 2022. A new class action lawsuit alleges Humana used an algorithm to deny care to Medicare Advantage patients. And, WW–formerly known as Weight Watchers–unveils its new telehealth service to prescribe blockbuster weight loss drugs. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Supreme Court agrees to review a lower federal court ruling that could curtail access to mifepristone…a key drug used in medication abortions. Massachusetts will remove stigmatizing mental health and prior drug use questions from its physician credentialing process. And, Nemours will launch a pediatric hospital-at-home program in 2024. That’s coming up on today’s episode of Gist Healthcare Daily.
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The House passes a broad healthcare bill targeting site neutral payments, price transparency, and pharmacy benefit managers. A congressional inquiry finds that the nation’s largest pharmacy chains share medical data with law enforcement without a warrant. And, Moody’s downgrades Walgreens rating to ‘junk’ amid the pharmacy company's recent healthcare strategy push. That’s coming up on today’s episode of Gist Healthcare Daily.
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Cigna and Humana abandon their reported merger. The FDA approves two groundbreaking gene therapies to treat sickle cell disease. And, Congressional lawmakers introduce a bill that would prevent Medicare payment cuts to physicians next year. That’s coming up on today’s episode of Gist Healthcare Daily.
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Hospitals in states with restrictions–or even bans–on abortions are providing their physicians with little guidance on how to provide emergency abortion care. State laws are often unclear and don’t spell out exactly which exceptions are permitted and which are not. This leaves hospitals–and physicians–in a tricky situation as they navigate providing care while avoiding liability.
On today’s episode, Washington Post national healthcare reporter Dan Diamond joins the podcast to talk about an article he recently co-authored that investigates how physicians and hospitals are navigating these laws.
You can read Dan and Caroline Kitchener’s article here.
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The Biden Administration will go after patents in an effort to bring down drug prices. Michigan’s governor signs two bills that increase fines for violence against healthcare workers. And, NorthShore-Edward-Elmhurst Health rebrands as Endeavor Health. That’s coming up on today’s episode of Gist Healthcare Daily.
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Contract negotiations between Adventist Health and Blue Shield of California break down. Residents at Northwestern Medicine announce they plan to unionize. And, a new study finds that the number of FDA drug manufacturer inspections dropped sharply after the beginning of the COVID-19 pandemic. That’s coming up on today’s episode of Gist Healthcare Daily.
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CVS unveils a new ‘cost plus’ drug pricing model meant to streamline the drug reimbursement process. States that don’t fix their Medicaid redeterminations issues could face a loss of federal funding and fines under an interim final rule. And, a cyberattack on a Corewell Health vendor exposes the personal data of one million of its patients. That’s coming up on today’s episode of Gist Healthcare Daily.
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North Carolina’s Medicaid expansion goes into effect. Community Health Systems finalizes its sale of three of its Florida hospitals to Tampa General. And, a House panel will investigate the Food and Drug Administration over its decision to declare certain oral, over-the-counter decongestants as ineffective. That’s coming up on today’s episode of Gist Healthcare Daily.
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In March, employee healthcare navigation company Transcarent announced it would acquire AI-powered primary care startup 98point6’s virtual care platform and care business. On today’s episode of Gist Healthcare Daily, we hear the second part of JC’s conversation with Transcarent CEO Glen Tullman about that acquisition and how it fits into his Transcarent’s long-term goals. They also discuss Tullman’s thoughts on the future of employer-sponsored healthcare.
You can find the first part of the conversation here.
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The Biden Administration will invoke the Defense Production Act to manufacture more drugs in the United States amid an ongoing shortage. The FTC announces it will investigate the safety of CAR-T therapies. And, Federal lawmakers introduce a bill that would ban fees for electronic healthcare payments. That’s coming up on today’s episode of Gist Healthcare Daily.
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Major health insurers Cigna and Humana are reportedly in talks to merge. The number of US physicians either employed by or affiliated with Optum swells to nearly 90,000. And, the merger between BJC HealthCare and St. Luke’s Health System is expected to close at the beginning of the year. That’s coming up on today’s episode of Gist Healthcare Daily.
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A massive data breach last week disrupts operations at a large, multi-state health system. Optum faces a federal lawsuit from a California hospital alleging antitrust violations. And, Fairview Health plans to end its current partnership with the University of Minnesota. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Biden Administration proposes a rule that could make dental care covered under Affordable Care Act plans.Hospitals and health system executives say investing in cyber security is their top investment priority for their 2024 IT budgets. And, a new survey finds that nearly half of American adults faced healthcare billing issues within the last year. That’s coming up on today’s episode of Gist Healthcare Daily.
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Employee healthcare navigation company Transcarent announced in September that it has partnered with an inaugural group of 10 large health systems to create what it calls a national, independent “provider ecosystem” in order to provide higher-quality care to the covered beneficiaries of its more than 300 employer clients. On today’s episode of Gist Healthcare Daily, Transcarent CEO Glen Tullman joins the show to talk more about the health system partnerships and the company’s direct contracting model.
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The American Medical Association releases its latest policy focuses…including pushing for diabetes drugs to be covered for weight loss. Medicare will cover navigation services for cancer patients under a new rule, And, around 36 million adults in the US have received the updated COVID shot. That’s coming up on today’s episode of Gist Healthcare Daily.
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UnitedHealth faces a lawsuit over its use of an algorithm in its Medicare Advantage denials. State Medicaid administrators anticipate a steep drop in enrollment and more spending on the program from state governments in 2024. And, the Biden Administration issues its final rule requiring nursing homes to be more transparent with their ownership information. That’s coming up on today’s episode of Gist Healthcare Daily.
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Amazon’s One Medical inks more partnerships with health systems across the country. New York lawmakers propose tighter cybersecurity restrictions for hospitals. And, life expectancy for men in the US drops to 73 years--six years less than women--according to a new study. That’s coming up on today’s episode of Gist Healthcare Daily.
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Health systems sue the Health Resources and Services Administration over its recent reversal of its 340B off-site clinic registration policy. Pharmacy benefit managers would face tighter restrictions under a new Senate bill. And, private equity firm Thoma Bravo finalizes its acquisition of electronic health records vendor NextGen. That’s coming up on today’s episode of Gist Healthcare Daily.
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On today’s episode of Gist Healthcare Daily, Brad Kittredge, founder and CEO of digital mental healthcare provider platform Brightside Health, joins to talk more about the services Brightside provides. He also discusses the organization’s recent announcement that it will expand access to Medicaid and Medicare populations through its partnerships with health insurers.
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Kaiser Permanente healthcare workers approve a new four-year contract a month after their historic, large-scale strike. Amazon offers a reduced membership price to One Medical for its Prime subscribers. And, the Food and Drug Administration approves Eli Lilly’s GLP-1 drug–tirzapetide–for chronic weight management. That’s coming up on today’s episode of Gist Healthcare Daily.
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Hospitals and health systems across the country have seen an alarming increase in both the frequency and severity of workplace violence incidents. Toni Ardabell, Chief of Clinical Enterprise Operations for Inova Health System in Falls Church, Virginia joins Gist Healthcare Daily to talk more about how Inova has created a multidisciplinary team to better address the issue and create a safer environment for staff and patients.
This episode originally aired on July 31, 2023
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The Biden Administration proposes stricter marketing rules for Medicare Advantage plans. North Carolina’s Attorney General threatens to sue for-profit health system HCA for violating its Mission Health purchasing agreement. And, the rate of hospital-acquired infections has dropped after a surge during the pandemic. That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS issues its final Medicare reimbursement rules for 2024, with outpatient facilities seeing a pay bump and physicians facing payment cuts. The American Hospital Association challenges the Department of Health and Human Services over its third-party web tracking rule in a new lawsuit. And, a new Minnesota law requires hospitals in the state to inform patients of financial assistance before collecting medical debt. That’s coming up on today’s episode of Gist Healthcare Daily.
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For months, federal lawmakers in Washington D.C. have been at odds over reauthorizing the United States President's Emergency Plan For AIDS Relief–better known as PEPFAR–a U.S. initiative to address the global HIV/AIDS epidemic. The program has largely had bipartisan support on the Hill since it was first introduced in 2003 under then-President George W. Bush's administration. However, in recent months, its reauthorization has been held up by Republicans who allege the funding is being used to pay for abortions overseas, a claim PEPFAR administrators have denied.
On today’s episode of Gist HealthcareDaily, Washington Post national health reporter Dan Diamond joins to talk more about the current fight on Capitol Hill and how it recently came to light that $1 billion in federal funds are being withheld from the program by Republican lawmakers.
Here’s some of Dan’s recent reporting on the issue:
- Republicans delay more than $1 billion in HIV program funding (Published: October 26, 2023)
- Lifesaving HIV program faces a new threat: U.S. abortion politics(Published: July 29, 2023)
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Walmart strikes a deal with Orlando Health, its first health system partnership. CMS backtracks on proposed home health Medicare payment cuts. And, infant mortality in the United States rose for the first time in two decades, according to a new report. That’s coming up on today’s episode of Gist Healthcare Daily.
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Health tech unicorn Olive AI winds down its operations and sells its assets. Ransomware attacks on healthcare organizations have cost the U-S economy more than $77 billion in downtime alone. And, new analysis from the Lown Institute finds that nearly a quarter of hospital stent procedures are unnecessary and drive up costs. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Department of Health and Human Services is proposing new penalties for providers that engage in information blocking. A new executive order from President Biden zeroes in on artificial intelligence, particularly in healthcare. And, pharmacists and workers at the nation’s largest pharmacy retail chains go on strike. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Department of Health and Human Services reverses its COVID-era 340B off-site clinic policy. The Biden Administration proposes an overhaul of the No Surprises Act’s independent dispute resolution process. And, the federal government will stop covering COVID drugs this week. That’s coming up on today’s episode of Gist Healthcare Daily.
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At this year’s HLTH conference in Las Vegas, Nevada, JC sat down with Sachin Jain, MD, CEO of SCAN Health Plan, a not-for-profit provider of Medicare Advantage plans based in Long Beach, California. They discuss SCAN’s planned merger with Care Oregon and broader competition in the MA market as well as the growing tension between providers and MA plans.
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Walmart expands a pilot benefit program that provides doula care for postpartum employees nationwide. CVS pulls some decongestants from shelves that were recently found to be ineffective. And, a new survey finds that healthcare is still unaffordable, even for those with insurance. That’s coming up on today’s episode of Gist Healthcare Daily.
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The CDC recommends rationing a RSV shot for babies due to shortages. The Senate HELP committee advances President Biden’s National Institutes of Health nominee, Dr. Monica Bertagnolli. And, a new survey finds that the number of healthcare workers experiencing workplace harassment doubled in 2022, and is negatively impacting their mental health. That’s coming up on today’s episode of Gist Healthcare Daily.
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Henry Ford Health and Ascension Michigan enter into a $10.5 billion joint venture. National vitamin and supplement retailer GNC gets into virtual telehealth. And, Georgia’s Medicaid work requirement expansion sees slow enrollment during its first quarter. That’s coming up on today’s episode of Gist Healthcare Daily.
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Blue Cross Blue Shield of North Carolina moves to buy FastMed urgent care centers in the state. More than nine million people have been removed from state Medicaid rolls six months into the redetermination process. And, new analysis looks at how many rural hospitals have switched to the new Rural Emergency Hospital designation. That’s coming up on today’s episode of Gist Healthcare Daily.
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Congressional committees have weighed legislation over the past months that would further regulate pharmacy benefit managers, if passed. But these bills may not have a significant impact on drug spending, and could even have the opposite of their intended effects, according to new analysis from the Brookings Institution. On today’s episode of Gist Healthcare Daily, Matthew Fiedler, Joseph A. Pechman Senior Fellow in Economic Studies at the Brookings Institution and senior fellow with the Brookings Schaeffer Initiative on Health Policy, joins to talk more about what he and his team found.
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Walgreens and startup health insurer Alignment Health partner on Medicare Advantage plans for 2024. Amazon’s One Medical quietly rebrands its Iora Health senior care clinics. And, new analysis finds that family premiums rose an average of 7% for employer-sponsored health coverage this year. That’s coming up on today’s episode of Gist Healthcare Daily.
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CMS has removed amyloid PET scan restrictions for Medicare beneficiaries. Novo Nordisk stops its Ozempic trial for treating kidney failure following early signs of the drug’s success. And, a new study finds that healthcare providers continue to leave the field in droves. That’s coming up on today’s episode of Gist Healthcare Daily.
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Hundreds of physicians at Allina Health vote to unionize. California raises the minimum wage for healthcare workers. And, Walgreens moves to close 60 VillageMD locations in an effort to cut costs. That’s coming up on today’s episode of Gist Healthcare Daily.
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Kaiser Permanente and the unions representing its healthcare workers who recently went on strike reach a tentative new contract agreement. National retail pharmacy chain Rite-Aid files for bankruptcy. And, the number of Medicare Advantage plans rated four stars or more drops for the 2024 plan year. That’s coming up on today’s episode of Gist Healthcare Daily.
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In early October, Providence Health unveiled Praia Health, its fourth, incubated technology. Praia utilizes what the Digital Innovation Group calls a digital flywheel to keep patients engaged with their care by personalizing individuals' health journeys and seamlessly connecting them to the right services, products and resources. On today’s episode, we hear the second half of JC’s conversation with Sara Vaezy, Executive Vice President and Chief Strategy and Digital Officer for Providence, where they talk more about Praia’s value proposition to hospitals and the future of the health system’s digital strategy.
You can listen to the first part of our conversation here.
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UnityPoint Health and Presbyterian Healthcare Services call off their proposed merger. California is one step closer to establishing universal health coverage for residents. And, AmSurg will officially split from parent company Envision, amid Envision’s bankruptcy restructuring. That’s coming up on today’s episode of Gist Healthcare Daily.
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Walgreens names former Cigna executive Tim Wentworth as its next CEO following the departure of its former chief executive Roz Brewer last month. And, some final updates from HLTH, including Walmart’s decision to expand its virtual primary care pilot to all of its employees and their families. That’s coming up on today’s episode of Gist Healthcare Daily.
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An estimated 10,000 people descended on Las Vegas this week to attend HLTH23, a three-day conference that brings together healthcare stakeholders from around the world. The conference reflects some of the biggest changes happening in health and tech, including this year’s star: artificial intelligence. That’s coming up on today’s episode of Gist Healthcare Daily.
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The fifth annual HLTH conference is currently underway in Las Vegas. Since it began in 2018, HLTH has become one of the premier healthcare and networking conferences in the country, bringing together healthcare stakeholders from the United States and across the globe. On today's episode of Gist Healthcare Daily, we have updates from the first two days of the conference, as well as some healthcare news updates from outside of HLTH.
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Renton, Washington-based health system Providence recently unveiled Praia Health, its latest incubated technology. Praia is a platform-as-a-service developed for health systems to increase patient engagement by personalizing individuals' health journeys and seamlessly connecting them to the right services, products and resources.
On today’s episode of Gist Healthcare Daily, Sara Vaezy, Executive Vice President and Chief Strategy and Digital Officer for Providence, joins to talk more about Praia Health, including its goals and the issues it aims to address.
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Minnesota’s Attorney General further scrutinizes two proposed cross-state health system mergers. Moderna’s combination flu and COVID vaccine advances to Phase 3 clinical trials. And, providers could face Medicare payment penalties under tougher quality program standards starting next year. That’s coming up on today’s episode of Gist Healthcare Daily.
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Tens of thousands of Kaiser healthcare workers go on strike across several states. Progressive lawmakers call for greater scrutiny of UnitedHealth's pending acquisition of home care group Amedisys. And, Instacart partners with health insurance startup Alignment Health on co-branded Medicare Advantage plans. That’s coming up on today’s episode of Gist Healthcare Daily.
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Public health programs and safety net hospitals will continue to get federal funding - at least temporarily. Drug makers agree to negotiate drug prices with Medicare, even as they continue their legal fight over the process. And, parents and caregivers across the country struggle to get COVID vaccines for children. That’s coming up on today’s episode of Gist Healthcare Daily.
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More than 75,000 Kaiser healthcare workers are set to strike across several states this week as their current employment contract expires. Cigna will pay $172 million to settle its Medicare Advantage fraud suit. And, a new report finds that the Center for Medicare and Medicaid Innovation has raised federal spending, not lowered it. That’s coming up on today’s episode of Gist Healthcare Daily.
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An estimated $100 billion in care is delivered every year in the infusion therapy market, and it’s expected to continue growing. Today, Uptiv Health CEO and co-founder Torben Nielsen joins the podcast to talk more about how Uptiv is trying to change the model for infusion care by providing hybrid, whole-person care in partnership with specialists and hospitals.
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Numerous hospitals and health systems have recently had their credit rating downgraded. The Biden Administration says insurance issues for the updated COVID vaccines have been largely resolved. And, Elevance and Blue Cross Blue Shield of Louisiana hit pause on their proposed merger. That’s coming up on today’s episode of Gist Healthcare Daily.
You can find the Kaufman Hall blog post referenced in the credit ratings story here.
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A new report finds that safety net care providers bought nearly $54 billion of 340B discounted drugs last year. The Biden Administration wants to remove medical debt from consumer credit reports. And, Cano Health sells its Nevada and Texas primary care clinics to Humana. That’s coming up on today’s episode of Gist Healthcare Daily.
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North Carolina will expand Medicaid before the end of the year…following a long budget approval process. President Biden signs a measure to overhaul the nation’s organ transplant system. And, employee healthcare navigation company Transcarent announces the launch of a new national provider network of 10 large nonprofit health systems. That’s coming up on today’s episode of Gist Healthcare Daily.
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More than 75,000 Kaiser workers sign on to a three-day strike as negotiations falter. The Centers for Disease Control and Prevention recommends the RSV vaccine for pregnant people. And, Costco is the latest major retailer getting into healthcare delivery. That’s coming up on today’s episode of Gist Healthcare Daily.
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The Centers for Medicare and Medicaid Services unveiled proposed rule changes in July that would require price data to be standardized across hospitals. On today’s episode, Turquoise Health CEO Chris Severn joins the podcast to talk more about the proposed rule and the state of healthcare price transparency in the market today.
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The Biden Administration announces it will again send free COVID tests to US households. CMS says parts of the No Surprises Act dispute resolution process can resume. And, the FTC sues US Anesthesia Partners and private equity firm Welsh Carson, alleging they formed a monopoly to drive up prices for services in Texas. That’s coming up on today’s episode of Gist Healthcare Daily.
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A hospital price transparency bill is pulled from the House floor. A recent ‘secret shopper’ study finds discrepancies between hospital prices quoted online versus over the phone. And, Bright Health reaches a risk-adjustment shortfall agreement with the federal government. That’s coming up on today’s episode of Gist Healthcare Daily.
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New analysis finds that more than 80% of nursing homes currently fall short of staffing levels being proposed by CMS. An FDA panel finds that the active ingredient in many over-the-counter decongestants is ineffective. And, Oracle announces it will add generative AI to its EHRs to help physicians reduce their workload. That’s coming up on today’s episode of Gist Healthcare Daily.
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Sixty-seven thousand Kaiser Permanente workers vote to authorize a strike. Dana-Farber and Beth Israel Deaconess partner on a new cancer center. And, Oregon approves a plan to create a new basic health plan for residents who earn too much to qualify for Medicaid. That’s coming up on today’s episode of Gist Healthcare Daily.
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The hospital-at-home care model is expected to expand significantly by the end of the decade, but questions remain about who will pay for it and how. On today’s episode of Gist Healthcare Daily, we hear the second part of our conversation with Rob Moskowitz, MD, Chief Medical Officer at Contessa Health, where we discuss the outlook for reimbursement as well as thoughts on the clinical staff needed to deliver the model at scale.
You can listen to the first part of our conversation here.
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A looming government shutdown could impact crucial healthcare programs. A new study conducted by the Blue Cross Blue Shield Association is the latest to find that outpatient care at hospitals is more expensive compared to surgery centers or physician’s offices. And, most ambulance rides are out of network, according to a new report. That’s coming up on today’s episode of Gist Healthcare Daily.
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California healthcare workers could see a pay raise under a new deal. The newest COVID vaccines will be available this week, but for the first time without the federal government guaranteeing they’ll be free. And, prescription opioid shipments dropped as fatal overdoses increased. That’s coming up on today’s episode of Gist Healthcare Daily.
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The FDA approves updated COVID vaccines amid a summer surge. Walgreens partners with provider enablement company Pearl Health to grow its value-based primary care business. And, Geisinger and Best Buy expand their at-home chronic disease management partnership. That’s coming up on today’s episode of Gist Healthcare Daily.
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Walmart is reportedly considering buying a majority stake in ChenMed. Two major hospital systems are switching their EHRs from Cerner to Epic. And, two Wisconsin health systems take another step towards a merger. That’s coming up on today’s episode of Gist Healthcare Daily.
Hospital-at-home has been around since the mid-1990s in the United States. But the broader adoption of the care model accelerated during the COVID-19 pandemic, in part due to patient preference and waivers from CMS. On today’s episode of Gist Healthcare Daily, Contessa Health Chief Medical Office Rob Moskowitz, MD joins the podcast to talk about the future of hospital-at-home and what needs to be in place to ensure its long-term success.
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A new study finds that Medicare Advantage plans were overpaid by billions of dollars each year from 2017 to 2020. The cost of employer-sponsored health insurance is expected to surge next year. And, researchers are investigating whether weight loss drugs Ozempic and Wegovy could be used to treat alcohol addiction and dementia. That’s coming up on today’s episode of Gist Healthcare Daily.
CMS unveils a new state-level all-payer model meant to improve population health. Electronic health records company NextGen goes private in a deal with private equity firm Thoma Bravo. And, a new study finds that primary care physicians affiliated with health systems drive up spending. That’s coming up on today’s episode of Gist Healthcare Daily.
Medicare names the first 10 drugs facing price negotiations. The Biden Administration proposes new nursing home staffing standards. And, Humana sues CMS to prevent Medicare payment clawbacks. That’s coming up on today’s episode of Gist Healthcare Daily.
Data sharing platform Health Gorilla surveyed more than 1,200 consumers to gauge their opinion about the privacy of their health data and which companies should be allowed to access it. It found a vast majority of respondents expressed concerns about data breaches affecting their medical records. Steven Lane, MD, Chief Medical Officer for Health Gorilla, joins the podcast to talk more about the survey, patient privacy, and the role of interoperability.
You can find Health Gorilla’s State of Patient Privacy report here.
A major insurer switches gears and partners with Amazon and Mark Cuban Cost Plus Drugs in a cost saving move. Portland, Oregon-based health systems Oregon Health & Science University and Legacy Health announce they intend to merge. And, a federal court maintains restrictions on the abortion pill–guaranteeing the case heads to the supreme court. That’s coming up on today’s episode of Gist Healthcare Daily.
The Centers for Medicare and Medicaid Services updates its ACO REACH model. Oregon’s governor signs a nurse-to-patient staffing ratio bill into law. And, new data show that private-equity healthcare deals slowed amid higher interest rates. That’s coming up on today’s episode of Gist Healthcare Daily.
AdventHealth sues MultiPlan--a company that provides regional preferred provider organization networks for insurers--alleging it colluded with those insurers to pay providers less for out-of-network care. Some health insurers say they won’t cover Alzheimer’s drug Leqembi. And, CMS says there are 27 states with concerning rates of Medicaid terminations due to procedural reasons. That’s coming up on today’s episode of Gist Healthcare Daily.
The Department of Justice requests more information about Optum’s planned acquisition of home health care company Amedisys. Cano Health announces it will lay off 700 employees as it looks to sell its business. And, the Biden Administration announces a $100 million investment to grow the nation’s nursing workforce. That’s coming up on today’s episode of Gist Healthcare Daily.
New antitrust proposals from the Department of Justice and the Federal Trade Commission would allow antitrust regulators greater authority to scrutinize healthcare mergers and acquisitions, if finalized. On today’s episode of Gist Healthcare Daily, we hear the second part of JC’s conversation with Stuart Vogelsmeier, EVP and Chair of the Healthcare and Business practices at St. Louis-based law firm Lashly & Baer, about how these proposed guidelines could impact healthcare transactions.
You can listen to the first part of our conversation here.
A new study finds that hospital prices for commercial plans are twice those for Medicare Advantage plans, even when negotiated by the same payer. The number of continuation patents is increasing as brand name drugmakers move to ward off generics. And, the American Red Cross implements the FDA’s recent policy change that allows gay and bisexual men to donate blood. That’s coming up on today’s episode of Gist Healthcare Daily.
The Department of Defense has partnered with a third-party lab to test generic medications over concerns of tainted drugs. The DEA is weighing a special registration that would allow some physicians to prescribe controlled medications through telehealth appointments. And, CMS updates its HCAHPS patient experience survey. That’s coming up on today’s episode of Gist Healthcare Daily.
Obesity drug Wegovy was found to lower cardiovascular risk by 20 percent in a large clinical trial. US Senators push the IRS to investigate nonprofit hospitals. And, Babylon Health’s plan to go private falls through. That’s coming up on today’s episode of Gist Healthcare Daily.
A Texas federal judge vacates portions of the No Surprises Act dispute resolution process. The FDA approves a new oral medication to treat postpartum depression but rejects its wider use for other mental health conditions. And, a cyber attack impacts hospitals owned by a private equity group across three states. That’s coming up on today’s episode of Gist Healthcare Daily.
The Federal Trade Commission and the Department of Justice’s latest antitrust proposals would allow the agencies greater authority to investigate potential mergers across all sectors of the US economy, including healthcare. On today’s episode of Gist Healthcare Daily, Stuart Vogelsmeier, EVP and Chair of the Healthcare and Business practices at St. Louis-based law firm Lashly & Baer, joins the podcast to talk more about the proposed guidelines and what they could mean for future healthcare deals.
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The National Institutes of Health taps its next infectious-disease chief. The family of Henrietta Lacks settles their lawsuit with a biotechnology company that used her cells without consent. And, the number of COVID-related hospitalizations is at its highest point since December. That’s coming up on today’s episode of Gist Healthcare Daily.
Hospitals will see a 3.1% inpatient payment increase next year, but some industry groups say it doesn’t go far enough. A bill that would overhaul the national organ donation system heads to President Biden’s desk. And, the US Department of Labor sues UnitedHealth over allegations that a subsidiary of the payer denied thousands of claims. That’s coming up on today’s episode of Gist Healthcare Daily.
CMS has notified around 612,000 Medicare beneficiaries whose information may have been affected in a data breach this spring. CMMI will pilot a care model for people with dementia and their caregivers. And, Amazon expands its direct-to-consumer telehealth clinic to all 50 states. That’s coming up on today’s episode of Gist Healthcare Daily.
Sanford Health and Fairview Health Services call off their planned merger. North Carolina's governor sets a date for Medicaid expansion as the fight over the state’s budget continues. And, CMS officially releases Medicaid redetermination data as of April. That’s coming up on today’s episode of Gist Healthcare Daily.
Hospitals and health systems across the country have seen an alarming increase in both the frequency and severity of workplace violence incidents. Toni Ardabell, Chief of Clinical Enterprise Operations for Inova Health System in Falls Church, Virginia joins Gist Healthcare Daily to talk more about how Inova has created a multidisciplinary team to better address the issue and create a safer environment for staff and patients.
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Key House and Senate Committees advance bills targeting pharmacy benefit manager practices. Amazon unveils its generative AI service for healthcare documentation software. And, a new report finds that the average cost of healthcare data breaches is now nearly $11 million. That’s coming up on today’s episode of Gist Healthcare Daily.
The city of Cleveland sues retail pharmacies, PBMs, and drugmakers over the cost of insulin. Community Health Systems will sell three of its Florida hospitals in a $290 million deal. And, a new report finds that hospitals are still struggling to discharge patients to post-acute care settings. That’s coming up on today’s episode of Gist Healthcare Daily.
The FTC and DOJ’s newly proposed merger guidelines could slow mergers and acquisition activity in the healthcare industry. The Biden Administration wants to require health insurers to provide better coverage for mental health needs. And, Cigna faces a lawsuit over its alleged use of an algorithm to deny claims. That’s coming up on today’s episode of Gist Healthcare Daily.
The White House launches a permanent pandemic office. Federal regulators warn hospitals and telehealth companies about technology that tracks patient data. And, recent tornado damage at a Pfizer plant in North Carolina highlights the fragility of the medical supply chain. That’s coming up on today’s episode of Gist Healthcare Daily.
In May, resident physicians at Elmhurst Hospital in Queens, New York went on strike for the first time in more than 30 years. On today’s episode of Gist Healthcare Daily, Rebecca Givan, PhD, associate professor of Labor Studies at Rutgers University, joins to discuss that recent strike and the current state of physician labor organizing.
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CMS cracks down on states that are out of compliance with the Medicaid redetermination process. Teladoc announces an expanded relationship with Microsoft to integrate more AI into telehealth visits. And, the Joint Commission will remove additional accreditation requirements. That’s coming up on today’s episode of Gist Healthcare Daily.
Fewer physicians own their own practices, according to a new report. Three nurse practitioners sue over a California law that prevents them from using the title “doctor.” And, rising temperatures and extreme heat cost the U-S healthcare system an additional 1-billion dollars every summer. That’s coming up on today’s episode of Gist Healthcare Daily.
CMS proposes cuts to Medicare physician pay in 2024. The FTC withdraws antitrust policy statements it says are “outdated”. And, the FDA approves an RSV antibody treatment for infants and young children. That’s coming up on today’s episode of Gist Healthcare Daily.
A new national survey from strategic healthcare communications firm Jarrard Inc. finds that almost half of physicians do not trust that their organization's leaders are honest and transparent, and that this trust gap could be adding to physician burnout. David Jarrard, Executive Chairman of Jarrard Inc., joins the podcast to talk more about the results of the survey and what hospital leaders can do to close that gap.
You can find the survey here.
The Food and Drug Administration approves the first over-the-counter birth control pill to be sold in the U.S. The Department of Health and Human Services seeks to reinstate Obama-era nondiscrimination policies. And, California lawmakers weigh raising the minimum wage for healthcare workers in the state. That’s coming up on today’s episode of Gist Healthcare Daily.
Aspirus Health in Wausau, Wisconsin and St. Luke’s Health in Duluth, Minnesota announce their intent to merge. Scottsdale, Arizona-based HonorHealth will buy 26 urgent care centers from FastMed. And, CVS Health’s pharmacy benefit manager partners with GoodRX on a drug discount program. That’s coming up on today’s episode of Gist Healthcare Daily.
The Food and Drug Administration allows more imports of cancer drugs from China amid an ongoing US shortage. There’s less money and fewer investors in digital health, according to a new study. And, 11 million HCA patients are impacted by a data breach. That’s coming up on today’s episode of Gist Healthcare Daily.
340B hospitals would get $9 billion in back payments under a CMS proposal. The Department of Health and Human Services and other federal agencies announce an investigation of medical credit cards. And, a political fight between the President and progressive Congressional lawmakers stalls the appointment of Biden’s pick to lead the National Institutes of Health. That’s coming up on today’s episode of Gist Healthcare Daily.
The Biden Administration proposes limits on short-term health insurance plans. The Food and Drug Administration grants full approval to an experimental Alzheimer’s disease treatment. And, healthcare costs are expected to rise 7 percent next year, according to a new report. That’s coming up on today’s episode of Gist Healthcare Daily.
A new report calls for reforms to the Medicare Advantage bonus program. U.S. News and World Report announces revised methodology for its “Best Hospitals” list amid criticism. And, South Dakota officially expands Medicaid. That’s coming up on today’s episode of Gist Healthcare Daily.
Insurtech company Bright Health sells off its last remaining insurance asset. Home health groups could see a cut to Medicare payments next year. And, a new study shows that the number of maternal deaths have more than doubled since 1999. That’s coming up on today’s episode of Gist Healthcare Daily.
Insurtech company Bright Health sells off its last remaining insurance asset. Home health groups could see a cut to Medicare payments next year. And, a new study shows that the number of maternal deaths have more than doubled since 1999. That’s coming up on today’s episode of Gist Healthcare Daily.
On today’s episode of Gist Healthcare Daily, chef and restaurateur Tom Colicchio–owner of Crafted Hospitality and lead judge of the long-running television program Top Chef–joins the podcast to talk about his Root & Sprig fast casual restaurant concept that he developed exclusively for hospital facilities. He recently opened his latest Root & Sprig at St. Francis Hospital and Heart Center in Roslyn, New York in partnership with Catholic Health and Health Hospitality Partners.
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The Joint Commission unveils a new health equity certification. Researchers finally solve the mystery surrounding why statins cause muscle weakness and pain. And, Eli Lilly’s new investigational obesity treatment is making waves for its weight loss potential. That’s coming up on today’s episode of Gist Healthcare Daily.
The FTC proposes a new rule that could slow healthcare deals. Georgia’s controversial Medicaid work requirements go into effect in just a few days. And, Virginia Mason Franciscan Health will partner with Optum Washington. That’s coming up on today’s episode of Gist Healthcare Daily.
The American Hospital Association resumes its opposition to site-neutral payments in a renewed push on Capitol Hill. Epic and Microsoft’s Nuance are partnering to bring more generative AI to EHRs. And, a new study finds that physician-owned hospitals commercial negotiated rates and cash prices are lower compared to other facilities. That’s coming up on today’s episode of Gist Healthcare Daily.
United will acquire Amedisys, after the home health organization backs out of its earlier merger agreement with Option Care Health. British telehealth provider Babylon Health announces it will go private. And, a major drugmaker lobbying group sues over Medicare’s drug price negotiation plan. That’s coming up on today’s episode of Gist Healthcare Daily.
On today’s episode of Gist Healthcare Daily, Patrick O'Shaughnessy, DO–CEO of Catholic Health on Long Island, New York–joins the podcast to talk more about his system’s growing partnership with Health Hospitality Partners. HHP works with health systems and third-party businesses to revitalize underused hospital spaces, like lobbies, gift shops, and more. Catholic Health recently opened a Root & Sprig restaurant at its St. Francis Hospital and Heart Center in Roslyn, New York.
You can hear JC’s conversation with HHP founder and CEO Dan Kodner here.
On today's episode of Gist Healthcare Daily, industry veteran Craig Samitt, MD, joins the podcast. His 30-year career has included leading Blue Cross and Blue Shield of Minnesota and Dean Health System. He shares more about his new role as CEO of Surround Care’s National Physician Enterprise and EVP at Navvis, as well as his thoughts on the current state of the healthcare industry.
This episode first aired on March 27, 2023
A recent survey from The Pew Research Center found that 60% of Americans are uncomfortable with healthcare providers relying on artificial intelligence to make diagnoses or recommend potential treatments. On today’s episode of Gist Healthcare Daily, Alec Tyson of Pew Research joins to talk more about what the survey reveals about public perception of AI in healthcare.
This episode first aired on March 6, 2023
The Federal Trade Commission announced in January a proposed ban on non-compete clauses in employment agreements. NCAs are used broadly by employers, including those in the healthcare industry. On today’s episode of Gist Healthcare Daily, Stuart Vogelsmeier–Executive Vice President and Chair of the Healthcare and Business practices at St. Louis, MO-based law firm Lashly & Baer – joins the podcast to talk about how hospital systems, physicians, and other healthcare workers could be impacted if the ban goes into effect.
This interview originally aired on February 27, 2023
On today’s episode of Gist Healthcare Daily, Dan Kodner–CEO and founder of Health Hospitality Partners–talks about how his company works with health systems to bring in third-party businesses to revitalize underused retail and dining spaces to improve the experience of patients, their families, and hospital staff.
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Healthcare spending in the United States could exceed $7 trillion by 2031. The American Medical Association hammers out its priorities–including recommendations for the use of AI in prior authorizations and a campaign to reform the Medicare payment rate–at its annual conference. And, New York becomes the latest state to extend postpartum Medicaid coverage. That’s coming up on today’s episode of Gist Healthcare Daily.
The Biden Administration offers additional aid to states during the Medicaid redetermination process. A new study finds that Medicare Advantage overpayments could exceed $75B this year. And, Walmart is partnering with Simple HealthKit to bring more at-home diagnostic tests to the market. That’s coming up on today’s episode of Gist Healthcare Daily.
The ACA’s preventive care mandate is restored–temporarily–while a lawsuit challenging it makes its way through the courts. HHS announces the second group of inflation-capped Part B prescriptions. And, New York City physicians call off a planned strike after reaching a with hospitals. That’s coming up on today’s episode of Gist Healthcare Daily.
An FDA advisory panel unanimously recommends granting traditional approval to an experimental Alzheimer’s treatment. HHS unveils a new program that helps pediatric healthcare providers pay off their student loans. And, a drug-resistant fungus that can be found in hospitals is associated with a 34% death rate. That’s coming up on today’s episode of Gist Healthcare Daily.
On today’s episode of Gist Healthcare Daily, Wisconsin Medical College Professor of Anesthesiology Jesse Ehrenfeld, MD, joins the podcast to talk more about his upcoming, year-long term as the President of the American Medical Association, the issues the organization want to address at the national level, and the changing nature of how US physicians practice medicine.
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CMS announces that it will pilot a new, value-based primary care model with providers in eight states. The FTC urges North Carolina lawmakers to drop a bill that would exempt UNC Health from antitrust laws. And, the Pentagon is reportedly developing a program to test the quality and safety of generic medications for service members. That’s coming up on today’s episode of Gist Healthcare Daily.
The Mayo Clinic partners with Google Cloud to expand its use of generative AI across the system. Another KKR-backed healthcare company is seeking bankruptcy protection. And, a new study finds that LGBT health coverage improved after both the Affordable Care Act and the Supreme Court’s 2015 same-sex marriage ruling. That’s coming up on today’s episode of Gist Healthcare Daily.
Merck sues the Biden Administration over the Medicare drug price negotiation program in the Inflation Reduction Act. Some hospitals’ outpatient clinics could face challenges prescribing 340B drugs following the removal of COVID-era guidance. And, a new study finds that insurance coverage of expensive new drugs like Ozempic does not guarantee adherence. That’s coming up on today’s episode of Gist Healthcare Daily.
UnitedHealth makes a surprise bid for Amedisys as the home health organization considers an earlier merger offer from Option Care. Some patients may benefit from less aggressive treatments for certain cancers. And, insurance company Friday Health Plans to shut down as more regulators get involved. That’s coming up on today’s episode of Gist Healthcare Daily.
On today’s episode of Gist Healthcare Daily, we hear the second part of JC’s conversation with Micky Tripathi, Ph.D., M.P.P., National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. In this conversation, they talk more about the proposed HTI-1 rule, including provisions regarding transparency in AI algorithms. They also discuss the Trusted Exchange Framework and Common Agreement (TEFCA), which aims to establish a universal floor for interoperability across the country.
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Two large Missouri-based health systems announce their intent to merge. The nation’s largest health insurer backtracks on a controversial prior authorization rule. And, CMS announces a plan that will allow Medicare beneficiaries access to new Alzheimer’s drugs. That’s coming up on today’s episode of Gist Healthcare Daily.
Kaiser pledges $10 million to support a Colorado safety-net health system. CVS Health expects to lose up to $1 billion after a drop in its Medicare Advantage star ratings. And, Florida officials defend the state’s Medicaid redeterminations after 250,000 state residents are kicked out of the program. That’s coming up on today’s episode of Gist Healthcare Daily.
Lawmakers reach a preliminary deal on raising the debt ceiling that allows clawbacks of COVID-19 funding but removes Medicaid work requirements. Postpartum individuals on Medicaid could potentially lose coverage during redeterminations. And, physician pay increased last year but has not kept pace with inflation. That’s coming up on today’s episode of Gist Healthcare Daily.
On today’s episode of Gist Healthcare Daily, we hear the first part of JC’s conversation with Micky Tripathi, Ph.D., M.P.P., National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. He joined the podcast to talk more about ONC’s recently released proposed rule, “Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing”--better known as HTI-1.
Resident physicians on strike in New York City have reached a tentative bargain. A survey finds that Medicaid beneficiaries were unaware that states could begin removing ineligible enrollees from the program. And, one in five seniors skip taking medications due to cost, according to a new study. That’s coming up on today’s episode of Gist Healthcare Daily.
Minnesota lawmakers pass a law establishing a public option health plan. Troubled insurtech company Bright Health sells its Zipnosis telehealth platform. And, pharmacy benefits managers will be subject to new transparency guidelines under newly proposed rules from CMS. That’s coming up on today’s episode of Gist Healthcare Daily.
Legislation that would have mandated nursing ratios in Minnesota hospitals fails to move forward as originally written. The Surgeon General issues a public advisory warning of the mental health risks posed by social media for young people. And, Epic announces that more than 20 health systems will commit to a nationwide interoperability framework. That’s coming up on today’s episode of Gist Healthcare Daily.
The U.S. is facing a record-high drug shortage, leaving doctors to find workarounds for care. A new proposed bill passed by a House subcommittee would require more transparency among pharmacy benefit managers. And, more than 150 resident physicians go on strike at a New York City hospital. That’s coming up on today’s episode of Gist Healthcare Daily.
Hospitals and health systems have long grappled with high contingent labor costs, and that issue was put into stark relief during the COVID-19 pandemic. Today on Gist Healthcare Daily, Jeff Niles, Executive Vice President of Healthcare Workforce Logistics, joins the podcast to talk more about how the company works with systems to establish private label, vendor-neutral contingent workforce solutions to bring down costs and increase fill rates.
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A federal appeals court hears the latest arguments in the case challenging the abortion pill. HCA Healthcare will buy 41 urgent care clinics in Texas. And, Senator Bernie Sanders makes the push–again–for Medicare for All. That’s coming up on today’s episode of Gist Healthcare Daily.
Providers raise the alarm over UnitedHealthcare’s new prior authorization rules for certain colonoscopies. President Biden taps his choice to lead the National Institutes of Health. And, a Food and Drug Administration advisory panel weighs recommending a vaccine to protect babies against RSV. That’s coming up on today’s episode of Gist Healthcare Daily.
A federal appeals court preserves the Affordable Care Act’s preventive care mandate for now. CVS will wind down its clinical trials unit. And, AmSurg will purchase Envision’s ambulatory surgical centers as the struggling physician staffing company files for bankruptcy. That’s coming up on today’s episode of Gist Healthcare Daily.
Burnout is prevalent among healthcare workers. On today's episode of Gist Healthcare Daily, Even Health co-founder and CEO David Black joins the show to talk about his company’s digital platform–Cabana–which provides professionally-moderated, anonymous peer support for healthcare workers.
This interview originally aired on February 13, 2023
More than 53% of physicians in the United state report experiencing burnout and 30% of respondents experiencing burnout for more than two years. On today’s episode of Gist Healthcare Daily, Ochsner Health’s Chief Wellness Officer Dr. Nigel Girgrah talks about how his health system is experimenting with platforms to support the mental health wellbeing of its 36,000 employees.
This interview previously aired on February 6, 2023
Drug manufacturers and pharmacy benefit managers are duking it on on Capitol Hill over the high cost of insulin. Oscar Health is the latest insurtech looking to exit the California health insurance market. And, a new study finds that one in five U.S. adults miss needed medical appointments when they do not have reliable transportation. That’s coming up on today’s episode of Gist Healthcare Daily.
After more than three years, the COVID-19 public health emergency declaration draws to a close. Physician staffing group Envision is reportedly planning to file for Chapter 11 bankruptcy. And, primary care provider Cano Health looks to sell some of its non-core assets. That’s coming up on today’s episode of Gist Healthcare Daily.
California lawmakers pass a bill that would provide 150-million dollars in emergency loans for struggling hospitals. A health panel now recommends that people get mammograms at age 40 instead of 50. And, members of two FDA advisory panels vote unanimously in favor of making birth control available over-the-counter for the first time. That’s coming up on today’s episode of Gist Healthcare Daily.
This episode has been updated to reflect the vote from the FDA's advisory panels regarding Opill.
Integrated delivery system Sutter Health could acquire outpatient provider Sansum Clinic. Infusion therapy provider Option Care announces it will acquire home health organization Amedisys. And, new analysis finds that more than a million people would lose coverage if Medicaid work requirements go into effect. That’s coming up on today’s episode of Gist Healthcare Daily.
For the last 15 years, ZocDoc has connected physicians and other healthcare professionals to patients seeking care through its tech-enabled online marketplace. On today’s episode of Gist Healthcare Daily, Oliver Kharraz, MD–Founder and CEO of ZocDoc–joins the show to talk about how the company looks at the evolution of patient acquisition.
You can check out ZocDoc’s recent white paper on patient acquisition here.
The DEA extends COVID-era telehealth prescribing flexibilities for controlled substances. The FDA approves the first-ever vaccine for respiratory syncytial virus for seniors. And, a new survey finds enrollment in entry-level nursing programs is down for the first time in two decades. That's coming up on today's episode of Gist Healthcare Daily.
Eli Lilly announces its new Alzheimer’s drug shows promise in treating the disease. The Biden Administration is set to drop its COVID-19 vaccination mandate for hospital employees. And, an arbitration panel hands Envision a victory over UnitedHealthcare over underpaid claims. That’s coming up on today’s episode of Gist Healthcare Daily.
Two state Blues plans announce that they will enter into an affiliation deal. Troubled insurtech Bright Health is seeking a buyer for its California Medicare Advantage plan. And, CMS will investigate two hospitals for denying emergency abortion care. That’s coming up on today’s episode of Gist Healthcare Daily.
On this episode of Gist Healthcare Daily, we hear the second part of our conversation with Privia Health leaders Mike Flammini, Chief Business Development Office and Jason Ross, Executive Vice President of Health Systems. They discuss how Privia’s model is adapting to a changing healthcare market as well as the recent news that Privia’s CEO Shawn Morris is stepping down. That’s coming up on today’s episode of Gist Healthcare Daily.
You can find the first half of our conversation here.
The Centers for Medicare and Medicaid Services is strengthening the enforcement of its hospital price transparency rules. HCA and medical tech company Augmedix announce a partnership to pilot the company’s AI-enabled speech recognition platform to aid provider documentation. And, Walmart Health announces its expanding its reach even further in 2024. That’s coming up on today’s episode of Gist Healthcare Daily.
The nation’s largest nonprofit health system--California-based Kaiser Permanente--will combine combine with Danville, Pennsylvania-based Geisinger Health. TPG and AmerisourceBergen will purchase Nashville-based OneOncology in a deal worth more than two-billion dollars. And, Washington state passes a law that sets hospital staffing requirements. That’s coming up on today’s episode of Gist Healthcare Daily.
The Supreme Court issues a ruling that maintains current access to the abortion pill mifepristone for now. Most major insurers say they will continue to cover preventive services without cost-sharing amid a legal fight challenging the ACA policy. And, the Department of Veterans Affairs halts its rollout of Oracle Cerner’s EHR “indefinitely”. That's coming up on today's episode of Gist Healthcare Daily.
On Gist Healthcare Daily, an in-depth discussion with Privia Health leaders Mike Flammini, Chief Business Development Officer, and Jason Ross, Executive Vice President of Health Systems. They join to talk more about some of the organization’s recent health system partnerships and how it’s working with physician groups to transition to value-based care.
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The Supreme Court extends the freeze on a lower court ruling limiting access to the abortion pill mifepristone. The Biden Administration unveils a new database showing hospice and home-health group ownership details. And, Mark Cuban’s prescription drug company partners with pharmacies to challenge pharmacy middlemen. That’s coming up on today’s episode of Gist Healthcare Daily.
The Biden Administration unveils a new plan to provide COVID vaccines and certain treatments for free to people without health insurance. SSM Health sues insurtech company Bright Health over alleged unpaid claims. And, the obstetrics specialty faces a decline in residency applicants. That’s coming up on today’s episode of Gist Healthcare Daily.
The Food and Drug Administration approves a second omicron booster for people at high-risk for COVID infections. Epic and Microsoft partner on bringing artificial intelligence to electronic health records. And, insurtech company Clover Health announces layoffs and operational changes as it seeks to turn a profit. That’s coming up on today’s episode of Gist Healthcare Daily.
Some Democratic-governor led states are stockpiling the abortion drug mifepristone in preparation for a Supreme Court ruling on it. A new survey analysis finds that 800,000 nurses are projected to leave the workforce by 2027. And, the Biden Administration extends some COVID-19 flexibilities for pharmacy workers. That’s coming up on today’s episode of Gist Healthcare Daily.
There are significant disparities along racial lines in the orthopedic speciality field. Black patients are 30% less likely to undergo total hip and knee replacements compared to white patients, even though rates of arthritis remain close to the same between the two groups. And those racial disparities extend to the field of orthopedic surgeons with fewer than 2% of Black orthopedic physicians practicing in the United States. On today's episode, we revisit JC’s November conversation with Alonzo Sexton, MD--co-founder and CEO of ATL Orthopedics. They talk more about his private practice and how it makes orthopedic care more accessible to an underserved community.
This episode previously ran on November 28, 022.
A series of competing legal rulings over the FDA’s authorization of a drug used in medication abortions will likely head to the Supreme Court. The Biden Administration proposes extending ACA and Medicaid benefits to immigrants brought into the U.S. illegally as children. And, a new study finds that people with long-COVID report greater struggles with accessing and affording healthcare compared to those without longer-term symptoms. That’s coming up on today’s episode of Gist Healthcare Daily.
The Biden Administration issues a proposed rule that would ban HIPAA-covered entities from sharing patient information that could be used to investigate abortions. The founders of Outcome Health have been found guilty in a federal fraud case. And, healthcare added 34,000 jobs last month. That’s coming up on today’s episode of Gist Healthcare Daily.
The Biden Administration will invest 5-billion dollars in the development of the next generation of coronavirus vaccines. CMS proposes a 2-point-8-percent pay bump for hospitals in 2024. And, two Wisconsin health systems announce their plan to merge. That’s coming up on today’s episode of Gist Healthcare Daily.
Two contradictory federal court rulings on the legality of a pill used in medication abortions creates more uncertainty for abortion access in the United States and the FDA’s authority. Prescription digital therapeutics company Pear Therapeutics files for bankruptcy. And, UnitedHealth Group has acquired large New York-based physician group Crystal Run Healthcare. That’s coming up on today’s episode of Gist Healthcare Daily.
On today’s episode of Gist Healthcare Daily, Kaufman Hall co-founder and Chair Ken Kaufman joins the podcast to discuss his recentblogthat examines Ford Motor Company’s decision to stop producing internal-combustion sedans, and talk about whether there are parallels for health system leaders to ponder about whether their traditional strategies are beginning to age out.
The Centers for Medicare and Medicaid Services issued its final 2024 rule for Medicare Advantage and Medicare Part D. The Food and Drug Administration seeks more clarity from drug manufacturers amid drug shortages. And, a second state places health insurer Friday Health Plans under supervision. That’s coming up on today’s episode of Gist Healthcare Daily.
The FTC orders gene-sequencing company Illumina to divest cancer-test developer Grail. The hospital industry pushes back against likely nursing home staff mandates in an upcoming CMS proposed rule. And, Mark Cuban’s prescription drug company will sell brand-name diabetes drugs for the first time. That’s coming up on today’s episode of Gist Healthcare Daily.
Sanford Health and Fairview Health postpone their merger until late summer at the earliest. Three directors of primary care company Cano Health resign and call for the removal of its CEO. And, Medicare’s so-called “go-broke” date has been pushed to 2031. That’s coming up on today’s episode of Gist Healthcare Daily.
The Biden Administration releases its final pay rate for 2024 Medicare Advantage plans. The University of Michigan and Sparrow Health complete their $7 billion merger. And, states can now begin the Medicaid redetermination process. That’s coming up on today’s episode of Gist Healthcare Daily.
A new national survey from strategic healthcare communications consulting firm Jarrard Inc. examines how the public currently perceives hospitals and their business practices. On today’s episode of Gist Healthcare Daily, Executive Chairman David Jarrard joins to discuss the results of the survey and what action steps hospitals should be considering.
This episode originally aired on February 20, 2023.
A federal judge in Texas strikes down an Affordable Care Act provision mandating no-cost preventive care. The state of Oregon weighs capping the number of patients assigned to a single nurse. And, a new study finds that telehealth for opioid use disorder is linked to a lower risk of fatal overdose. That’s coming up on today’s episode of Gist Healthcare Daily.
A major health insurer announces that they will loosen their prior authorization rules. The Food and Drug Administration approves the over-the-counter use of an opioid overdose antidote. And, the state of Ohio files a lawsuit against pharmacy benefit managers. That’s coming up on today’s episode of Gist Healthcare Daily.
A veteran insurance executive has been named the new CEO of insurtech company Oscar Health Oak Street Health and Interwell Health are partnering on a joint venture that will bring primary care to dialysis centers. And, anew analysis finds that staffing at hospitals and health systems is returning to pre-pandemic levels. That’s coming up on today’s episode of Gist Healthcare Daily.
CVS Health is expected to complete its $8 billion purchase of Signify Health this week. The state of Tennessee has taken over the finances of troubled insurtech company Bright Health. And, a new survey finds more physicians want to leave their jobs as pay rates fall. That’s coming up on today’s episode of Gist Healthcare Daily.
On today's episode of Gist Healthcare Daily, industry veteran Craig Samitt, MD, joins the podcast. His 30-year career has included leading Blue Cross and Blue Shield of Minnesota and Dean Health System. He shares more about his new role as CEO of Surround Care’s National Physician Enterprise and EVP at Navvis, as well as his thoughts on the current state of the healthcare industry.
A Wyoming judge temporarily blocks the state’s expansive new abortion ban. Ongoing drug shortages could be a national security risk, according to a new Congressional report. And, the CDC warns that a potentially deadly fungus is spreading in hospitals. That’s coming up on today’s episode of Gist Healthcare Daily.
North Carolina is poised to expand Medicaid. The Biden Administration seeks to overhaul the nation’s organ transplant system. And, the Department of Justice and two states drop their suit challenging the merger of United Healthcare Group and Change Health. That’s coming up on today’s episode of Gist Healthcare Daily.
CMS restarts the No Surprises Act arbitration process following legal challenges. The maternal mortality rate in the United States increased significantly in 2021. And, California partners with CivicaRX to begin producing low-cost insulin. That’s coming up on today’s episode of Gist Healthcare Daily.
On last week’s Monday episode, obesity specialist Veronica Johnson, MD, joined the show to give an overview about how GLP-1 drugs like Ozempic work and how they’re being incorporated into patient care. On this week’s episode, we hear the second part of that conversation and delve into the shortages of the medication as well as other access barriers faced by some patients.
You can listen to part one of that conversation here.
A new long term study finds that men with low to intermediate risk from prostate cancer can afford to delay some treatments. A new report finds that the rate of SIDS increased for Black babies in 2020. And, early-career physicians employed by UK’s National Health Service went on strike this week. That’s coming up on today’s episode of Gist Healthcare Daily.
The Biden Administration will fine the drug manufacturers of 27 medicines for sharp price increases. The FDA approves Pfizer’s bivalent COVID booster for children as young as six months. And, the FDA says that Paxlovid is not responsible for rebound infections of COVID-19 ahead of an advisory committee meeting. That’s coming up on today’s episode of Gist Healthcare Daily.
Novo Nordisk announces it will cut the cost of its insulin up to 75 percent. The Department of Veterans Affairs says it will cover the experimental Alzheimer’s drug Leqembi for veterans in the early stages of the disease. And, the Department of Justice sues pharmacy chain Rite Aid for its role in the opioid epidemic. That’s coming up on today’s episode of Gist Healthcare Daily.
A failed bank utilized by tech companies and venture capitalists may have an impact on digital health startups. Policy experts warn that covering popular weight loss drugs like Wegovy could put a financial strain on Medicare. And, a new report finds that 15% of US adults are past-due on medical bills. That’s coming up on today’s episode of Gist Healthcare Daily.
Prescription drugs meant to treat chronic conditions like type 2 diabetes and obesity have caught the public’s attention for one of their side effects: weight loss. On today’s episode of Gist Healthcare Daily, we hear the first part of a two-part conversation about GLP-1 drugs, from an overview of how they work to how they are being incorporated into patient care. Veronica Johnson, MD of Northwestern University joins the podcast.
California pulls its multi-million contract with Walgreens over the company’s recent abortion pill decision. Lobbying group PhRMA and community health centers unite in calls for reforms to the 340B program. And, the manufacturer of a treatment to prevent preterm births pulls its drug from the market following scrutiny. That’s coming up on today’s episode of Gist Healthcare Daily.
WeightWatchers moves into the Ozempic market with its acquisition of telehealth company Sequence. Best Buy partners with Atrium Health to provide in-home hospital services. And, Walgreens-backed VillageMD acquires a large Connecticut-based physician group. That's coming up on today's episode of Gist Healthcare Daily.
In 2022, CommonSpirit–the second largest hospital chain in the United States–was the target of a ransomware attack that hobbled operations at many of its 140 hospitals and exposed the private health information of more than 600,000 patients.
The attack on CommonSpirit was the largest ransomware attack in 2022 but it was hardly an isolated incident. One analysis found that up to 290 hospitals in the U-S were impacted by a ransomware attack last year. And a new study published in JAMA found that from January 2016 to December 2021, 374 ransomware attacks on US health care organizations exposed the private health information of nearly 42 million patients. So what can hospital systems do to better protect themselves and their patients?
On today’s episode of Gist Healthcare Daily, J. Carlisle Larsen is joined by Steve Cagle–CEO of Clearwater, a firm that provides cybersecurity, compliance, and privacy solutions focused on the healthcare industry.
This episode originally aired on January 9, 2023.
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Walgreens won’t sell abortion pills in states where Republican Attorneys General object. UnityPoint Health and Presbyterian Healthcare Services have announced their intent to merge in a multi-billion dollar deal. And, a new survey finds that physicians are nearly twice as likely as the general population to attempt suicide. That's coming up on today's episode of Gist Healthcare Daily.
A recent survey from The Pew Research Center found that 60% of Americans are uncomfortable with healthcare providers relying on artificial intelligence to make diagnoses or recommend potential treatments. On today’s episode of Gist Healthcare Daily, Alec Tyson of Pew Research joins to talk more about what the survey reveals about public perception of AI in healthcare.
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Walmart Health announces that it’s expanding into two new states and will nearly double in size. FDA advisors recommend two new RSV vaccines for seniors. And, a new study found that most primary care telehealth visits did not require an in-person follow-up. That's coming up on today's episode of Gist Healthcare Daily.
Drug manufacturer Eli Lilly cuts insulin prices after public and political backlash. Insurtech Bright Health tells investors it needs to raise $300 million to stay afloat. And, greater numbers of younger people are being diagnosed with advanced cases of colorectal cancers, according to a new study. That's coming up on today's episode of Gist Healthcare Daily.
Medicare Advantage patients account for fewer avoidable hospitalizations. Medical claims are increasing in complexity, according to a new report. And, Wall Street is betting big on psychedelic drugs. That's coming up on today's episode of Gist Healthcare Daily.
The Drug Enforcement Administration seeks to limit what kinds of drugs can be prescribed during telehealth visits after the PHE ends. An Affordable Care Act provision that effectively bans expanding or establishing new physician-owned hospitals is getting more attention from regulators and lawmakers. And there’s a new, combination at-home testing option for both COVID-19 and the flu. That's coming up on today's episode of Gist Healthcare Daily.
The Federal Trade Commission announced in January a proposed ban on non-compete clauses in employment agreements. NCAs are used broadly by employers, including those in the healthcare industry. On today’s episode of Gist Healthcare Daily, Stuart Vogelsmeier–Executive Vice President and Chair of the Healthcare and Business practices at St. Louis, MO-based law firm Lashly & Baer – joins the podcast to talk about how hospital systems, physicians, and other healthcare workers could be impacted if the ban goes into effect.
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Humana announces it will leave the employer insurance market. The merger between Trinity Health’s MercyOne and Genesis Health System is expected to close next week. And, the popularity of prescription drugs that can be used off-label for weight loss–like Ozempic–is causing a shortage for people with type 2 diabetes. That's coming up on today's episode of Gist Healthcare Daily.
Amazon finalizes its purchase of primary care provider One Medical. Medicare Advantage grew last year but at a slightly slower rate than in previous years. And, a new survey examines the surge hospitals saw in 2022 payroll spending. That's coming up on today's episode of Gist Healthcare Daily.
More than 60% of Medicaid beneficiaries are unaware that state redeterminations are on the horizon. The U.S. Department of Justice has withdrawn three antitrust policies related to the healthcare industry. And, according to new research, we have not seen an uptick in the number of cancer cases as Americans postponed screenings due to COVID--at least not yet. That's coming up on today's episode of Gist Healthcare Daily.
A proposed merger between SUNY Upstate Medical School and Crouse Health System in Syracuse, New York has been called off. UnitedHealth is close to finalizing its acquisition of home care company LHC Group. And, Senate lawmakers raise the alarm over a potential healthcare worker shortage at a recent committee hearing. That's coming up on today's episode of Gist Healthcare Daily.
A new national survey from strategic healthcare communications consulting firm Jarrard Inc. examines how the public currently perceives hospitals and their business practices. On today’s episode of Gist Healthcare Daily, Executive Chairman David Jarrard joins to discuss the results of the survey and what action steps hospitals should be considering.
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A joint FDA advisory panel recommends Narcan nasal spray be available over the counter. Moderna says its COVID-19 vaccine will remain free for U.S. consumers. And, physicians can try a new AI tool to help with some administrative tasks. That's coming up on today's episode of Gist Healthcare Daily.
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The Biden Administration announces three new drug pricing models. State Attorneys General gear up for a fight over abortion pill access. And, South Dakota becomes the second state this year to ban gender-affirming care for transgender minors. That's coming up on today's episode of Gist Healthcare Daily.
Sanford Health and Fairview Health Services have pushed back their proposed merger by two months. The CDC raises new mental health concerns for teenage girls. And, the Biden Administration wants nursing homes to disclose whether they’re backed by private equity. That's coming up on today's episode of Gist Healthcare Daily.
Some Kansas lawmakers want to see the state become the latest to expand Medicaid. The Biden administration allows states to use Medicaid funds for food. Johns Hopkins University will sunset its influential COVID-19 tracking dashboard. And, a brief update on the surprise billing arbitration process. That's coming up on today's episode of Gist Healthcare Daily.
Burnout is prevalent among healthcare workers. In this week’s Monday interview, Even Health co-founder and CEO David Black joins the show to talk about his company’s digital platform–Cabana–which provides professionally-moderated, anonymous peer support for healthcare workers. That's coming up on today's episode of Gist Healthcare Daily.
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North Carolina could become the latest state to expand Medicaid. Minnesota lawmakers weigh opening its state-run insurance plan to all residents. And, National Health Service nurses and ambulance service staff strike in the United Kingdom. That's coming up on today's episode of Gist Healthcare Daily.
President Biden targeted drug costs and potential threats to Medicare in his 2023 State of the Union Address earlier this week. A new study looks at the number of excess physician deaths early in the pandemic. And, the labor market added 58,000 healthcare jobs last month. That's coming up on today's episode of Gist Healthcare Daily.
CVS is again rumored to be in talks to purchase primary care provider Oak Street Health. A judge strikes down key parts of the surprise billing arbitration process. And, a potential treatment for RSV may be out of reach for kids in need. That's coming up on today's episode of Gist Healthcare Daily.
More than 35 million prior authorization requests were sent to Medicare Advantage plans in 2021, according to a new study. Some health experts are calling for the FDA to review its accelerated approval process for Alzheimer’s drugs. And, states are investigating changing scope of practice laws to ease current healthcare staffing woes. That's coming up on today's episode of Gist Healthcare Daily.
More than 53% of physicians in the United States report experiencing burnout and 30% of respondents experiencing burnout for more than two years. On today’s episode of Gist Healthcare Daily, Ochsner Health’s Chief Wellness Officer Dr. Nigel Girgrah talks about how his health system is piloting with platforms to support the mental health wellbeing of its 36,000 employees.
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A federal court rules in favor of three drugmakers this week in the ongoing legal fight over the federal 340B drug discount program. CMS releases its proposed pay rate for 2024 Medicare Advantage plans. And, 20 state Attorneys General warn CVS and Walgreens against selling abortion pills. That's coming up on today's episode of Gist Healthcare Daily.
The Centers for Medicare and Medicaid Services issues a final rule on how it will audit Medicare Advantage insurers. The Biden Administration proposes rolling back employers’ moral opt-out to the Affordable Care Act contraceptive mandate. And, the Federal Trade Commission orders prescription drug price-tracking company GoodRX to stop sharing patient data with advertisers. That's coming up on today's episode of Gist Healthcare Daily.
The Biden Administration announces it will end the COVID-19 national and public health emergencies in May. =More states move to reduce prior authorization requirements for physicians. And, more medical schools are pulling out of U.S. News’ annual rankings. That's coming up on today's episode of Gist Healthcare Daily.
The Minnesota Attorney General’s office has asked Sanford Health and Fairview Health Services to delay their proposed $14 billion merger. The FDA is proposing a change that would loosen restrictions on blood donations from gay and bisexual men. And, CVS and Walmart are scaling back pharmacy hours due to a staffing shortage. That's coming up on today's episode of Gist Healthcare Daily.
There are roughly 53 million people in the United States who are unpaid caregivers. On today’s episode of Gist Healthcare Daily, Alexandra Drane–co-founder and CEO of ARCHANGELS–joins the show to talk about unpaid caregiving. Her organization conducts research on the broader unpaid caregiving population in order to raise awareness and help companies and state governments locate resources to assist unpaid caregivers.
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Mergers in the United States are expected to cost more beginning this year. A new study looks at what happened to beneficiaries after they lose Medicaid coverage. And, Kroger is the latest retailer to get into the clinical trials business. That's coming up on today's episode of Gist Healthcare Daily.
A U.S. drug manufacturer is suing West Virginia over the state’s abortion pill ban. It’s been two years since a federal hospital pricing transparency rule went into effect - so how are hospitals faring? And, more than 16 million people signed up for healthcare during the most recent ACA marketplace open enrollment period. That's coming up on today's episode of Gist Healthcare Daily.
Amazon announced a new subscription plan for generic prescription drugs. Elevance will acquire Blue Cross Blue Shield of Louisiana. And a new strain of gonorrhea found in Massachusetts is raising concerns among public health officials. That's coming up on today's episode of Gist Healthcare Daily.
The FDA denied accelerated approval for Eli Lilly’s experimental Alzheimer’s drug. Coronavirus shots may be delivered annually--similar to flu vaccines--under a newly proposed FDA policy. And, Dollar General is piloting a mobile healthcare clinic program in Tennessee. That's coming up on today's episode of Gist Healthcare Daily.
Congress extended Medicare’s hospital-at-home waiver at the end of last year in its $1.7 trillion omnibus spending package. On today’s episode of Gist Healthcare Daily, Dr. Pippa Shulman of Medically Home joins host J. Carlisle Larsen to talk more about the future of that care model.
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Veterans in suicidal crisis can now receive free emergency care at any VA or non-VA hospital, a shift in Veterans Affairs policy. The number of women in the United States becoming physicians is growing. And, Ochsner Health and Xavier University plan to start a new medical school together. That's coming up on today's episode of Gist Healthcare Daily.
The number of Americans putting off healthcare due to cost has reached a new high, according to a recent poll. The Biden Administration will probe the use of antipsychotics in nursing homes. And, a new report shows which codes have dominated the Independent Dispute Resolution process of the No Surprises Act. That's coming up on today's episode of Gist Healthcare Daily.
Milwaukee, Wisconsin-based Ascension Columbia St. Mary’s Hospital is postponing non-urgent surgeries for 30 days amid a staffing shortage. The CDC and FDA report a possible link between Pfizer's bivalent Omicron booster and strokes in people over 65. And, the state of California sues pharmacy benefit managers and drug makers over the cost of insulin. That's coming up on today's episode of Gist Healthcare Daily.
The healthcare industry has experienced a lot of challenges and seen a lot of innovations over the last year. On today's episode of Gist Healthcare Daily, Gist Healthcare co-presidents Chas Roades and Dr. Lisa Bielamowicz joined the podcast to give their take on what healthcare could look like in 2023.
The Biden Administration extended the COVID public health emergency again this week--potentially for the final time. The Department of Health and Human Services announced key implementation dates for Medicare drug price negotiations. And, insurtech companies outline their priorities for 2023 and beyond. That's coming up on today's episode of Gist Healthcare Daily.
A federal judge has ruled that HHS can create its repayment plan to 340b hospitals to the dismay of hospital lobbying groups. Intermountain Healthcare is partnering with Colorado’s UC Health to create a combined clinically integrated physician network in in the state. And, the U.S. healthcare sector added 55,000 jobs in December. That's coming up on today's episode of Gist Healthcare Daily.
Tech-enabled primary care provider Carbon Health has secured $100 million dollars in new funding from CVS Health. Digital health funding declined significantly in 2022 after breaking records in 2021. And, the American Academy of Pediatrics is now recommending early intervention for childhood cases of obesity. That's coming up on today's episode of Gist Healthcare Daily.
Gist Healthcare joins healthcare management consultancy group Kaufman Hall. Biogen’s latest Alzheimer’s drug lecanemab was granted accelerated approval by the FDA. And, the FTC has proposed a ban on non-compete agreements, which could impact how the healthcare industry operates. That's coming up on today's episode of Gist Healthcare Daily.
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In 2022, CommonSpirit–the second largest hospital chain in the United States–was the target of a ransomware attack that hobbled operations at many of its 140 hospitals and exposed the private health information of more than 600-thousand patients. The system is now facing the potential of a class action lawsuit following the breach.
The attack on CommonSpirit was the largest ransomware attack in 2022 but it was hardly an isolated incident. One analysis found that up to 290 hospitals in the U-S were impacted by a ransomware attack last year. And a new study published in JAMA found that from January 2016 to December 2021, 374 ransomware attacks on US health care organizations exposed the private health information of nearly 42 million patients. So what can hospital systems do to better protect themselves and their patients?
On today’s episode of Gist Healthcare Daily, J. Carlisle Larsen is joined by Steve Cagle–CEO of Clearwater, a firm that provides cybersecurity, compliance, and privacy solutions focused on the healthcare industry.
Hosted on Acast. See acast.com/privacy for more information.
One in three Americans had a mental illness or substance use disorder in 2021, according to a new survey. OSHA is expected to release its final COVID-19 safety guidelines for healthcare workers this month. And, New York is one of the latest states to require co-prescribed naloxone for some patients using opioids. That's coming up on today's episode of Gist Healthcare Daily.
An FDA rule change would allow retail pharmacies to provide prescription abortion pills. Some states that banned abortions are now weighing Medicaid expansion for new mothers. And, the Department of Health and Human Services has issued a proposed rule that changes how the healthcare sector handles conscience and religious objections. That's coming up on today's episode of Gist Healthcare Daily.
A new Omicron variant is quickly spreading through the United States. A new Congressional report finds irregularities with the FDA’s accelerated approval for the Alzheimer’s drug Adulhelm. And, medical bill disputes between payers and providers are overwhelming the resolution system set up following the No Surprises Act. That's coming up on today's episode of Gist Healthcare Daily.
Congress’ year-end spending bill has been finalized and includes changes to the FDA’s accelerated approval process. A new study finds high-intensity billing in emergency departments is increasing but it’s not just due to upcoding. And, the Biden Administration will release flu medicine from the national stockpile as the rate of infections increases. That's coming up on today's episode of Gist Healthcare Daily.
The Joint Commission is eliminating some of its quality standards as it seeks to streamline hospital safety and quality goals. The Biden Administration will publish ownership data for all hospitals that participate in Medicare. And, parents in the U-S are struggling to find pediatric beds for kids sick with RSV or the flu. That's coming up on today's episode of Gist Healthcare Daily.
Congress reportedly has reached a deal that would ease cuts to Medicare physician payments in 2023. Payers will need to provide an online-based price comparison tool as part of a the latest CMS requirements going into effect on January 1st. And, online pharmacy Truepill could be in trouble with the DEA over allegations that it unlawfully dispensed stimulants for ADHD.
Blue Cross Blue Shield of Massachusetts is including health equity measures in new value-based payment contracts. The Biden Administration seeks to extend opioid treatment flexibilities put in place through the COVID-19 public health emergency. And new data shows that overall U.S. healthcare spending slowed in 2021 as federal COVID funding subsided. That's coming up on today's episode of Gist Healthcare Daily.
Two west coast nonprofit managed care insurers announced merger plans. Blue Cross Blue Shield of Michigan has struck new full-risk Medicare Advantage contracts with six large physician groups. And, a new study finds that emergency department physicians misdiagnose serious conditions when patients exhibit unusual symptoms. That's coming up on today's episode of Gist Healthcare Daily.
The CDC says long COVID is responsible for thousands of deaths in the U.S. More for-profit healthcare organizations are reportedly at risk for credit default…with the vast majority of those being owned by private equity firms. And, new data shows the staffing challenges facing many not-for-profit hospital systems may be easing slightly. That's coming up on today's episode of Gist Healthcare Daily.
HHS signaled that healthcare systems can rely on COVID-19 public health emergency flexibilities as flu and RSV cases strain hospitals. CMS is proposing big changes to health insurance exchanges. And, researchers find that the COVID-19 vaccine saved the U.S. healthcare system more than $1 trillion. That's coming up on today's episode of Gist Healthcare Daily.
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A federal appeals court has struck down a Biden Administration policy protecting gender-affirming care under the Affordable Care Act’s nondiscrimination regulations. A Montana law barring employers from mandating COVID-19 vaccines has been deemed unconstitutional in healthcare settings. And, a new California law could bring more scrutiny to healthcare mergers & acquisitions. That's all coming up on today's episode of Gist Healthcare Daily.
The FDA has authorized the use of the Omicron-specific bivalent booster in children as young as six months. University of Michigan Health announced it will acquire Sparrow Health. And, a new study evaluates the risks of seniors undergoing major surgery. That's coming up on today's episode of Gist Healthcare Daily.
Employers across the US are expecting a spike in health care costs in 2023. Mark Cuban Cost Plus Drug Company has partnered with the Purchaser Business Group on Health, a large employer coalition. And, former-Theranos executive Sunny Balwani has been sentenced to prison after being convicted for fraud. That's coming up on today's episode of Gist Healthcare Daily.
CMS is proposing a new rule to streamline prior authorization for payers. UnitedHealth Group’s proposed $5 billion acquisition of a home health provider is on pause. And, new research finds the incidence of heart inflammation following a COVID-19 vaccine is very low among young people. That's coming up on today's episode of Gist Healthcare Daily.
Congress will likely repeal a COVID-19 vaccination mandate for US armed service members, despite opposition from the White House. New research finds that as many as 18 million Americans may lose their Medicaid coverage once the COVID-19 public health emergency ends. And, flu-related hospitalizations are on the rise. That's coming up on today's episode of Gist Healthcare Daily.
The nation’s largest for-profit health systems had their best operating margins during the COVID-19 pandemic. Several physicians groups have filed a legal brief in support of the ACA’s preventive care provision as it’s being challenged in federal court. And, Pfizer has applied for FDA emergency use authorization for its Omicron booster in children under the age of five. That's all coming up on today's episode of Gist Healthcare Daily.
Atrium and Advocate Aurora have finalized their merger, creating the fifth-largest nonprofit health system in the country. A soon-to-be implemented California law aimed at stopping physicians from spreading medical misinformation is already being challenged in court. And, the FDA will ease some donor restrictions amid a national blood shortage.
A study finds that the post- ACA drop in hospital readmissions may actually be due to how systems classified patient stays. A proposed House bill aims to reform how Medicare covers certain drugs. And, researchers may be one step closer to developing a universal flu vaccine. That's all coming up on today's episode of Gist Healthcare Daily.
A new Alzheimer’s drug has shown promise in slowing cognitive decline in Phase 3 clinical trials but concerns remain about its safety. Former MetroHealth CEO Akram Boutros is suing the hospital system and its board of trustees for violating Ohio’s Open Meetings Act--and its own bylaws--when it fired him. And Twitter has quietly stopped enforcing its COVID-19 misinformation policy. That's coming up on today's episode of Gist Healthcare Daily.
Research finds that so-called “skinny labeling” which allows drug makers to sell generics for off-patent use saved Medicare around $1.5 billion, but a legal fight could upend the practice. The Center for Medicare and Medicaid Services new Direct Contracting Model saved the agency $70 million during its inaugural year. And CMS is warning hospital systems to do more to protect staff and patients. That's coming up on today's episode of Gist Healthcare Daily.
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Greater numbers of Americans are buying health insurance on the ACA exchanges during the current open enrollment period. The WHO has changed the name of the “monkeypox” virus to “mpox”, following criticism that the former name exacerbates stigma. And several large health systems are now charging patients for some communications with their physicians through online patient portals. That's coming up on today's episode of Gist Healthcare Daily.
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There are significant disparities along racial lines in the orthopedic speciality field. Black patients are 30% less likely to undergo total hip and knee replacements compared to white patients, even though rates of arthritis remain close to the same between the two groups. And those racial disparities extend to the field of orthopedic surgeons with fewer than 2% of Black orthopedic physicians practicing in the United States. On today's episode, we replay our conversation with Dr. Alonzo Sexton--co-founder and CEO of ATL Orthopedics. He joined Gist Healthcare Daily to talk more about his private practice and how it makes orthopedic care more accessible to an underserved community.
Hosted on Acast. See acast.com/privacy for more information.
There are significant disparities along racial lines in the orthopedic speciality field. Black patients are 30% less likely to undergo total hip and knee replacements compared to white patients, even though rates of arthritis remain close to the same between the two groups. And those racial disparities extend to the field of orthopedic surgeons with fewer than 2% of Black orthopedic physicians practicing in the United States. On today's episode, we replay our conversation with Dr. Alonzo Sexton--co-founder and CEO of ATL Orthopedics. He joined Gist Healthcare Daily to talk more about his private practice and how it makes orthopedic care more accessible to an underserved community.
Hosted on Acast. See acast.com/privacy for more information.
There are significant disparities along racial lines in the orthopedic speciality field. Black patients are 30% less likely to undergo total hip and knee replacements compared to white patients, even though rates of arthritis remain close to the same between the two groups. And those racial disparities extend to the field of orthopedic surgeons with fewer than 2% of Black orthopedic physicians practicing in the United States. On today's episode, we replay our conversation with Dr. Alonzo Sexton--co-founder and CEO of ATL Orthopedics. He joined Gist Healthcare Daily to talk more about his private practice and how it makes orthopedic care more accessible to an underserved community.
Hosted on Acast. See acast.com/privacy for more information.
The state of Georgia may enforce work requirements for residents to qualify for expanded Medicaid. The longtime CEO of Cleveland-based MetroHealth was fired over nearly $2 million in alleged unauthorized bonuses that he gave to himself. And Bellin Health and Gundersen Health System are on track to finalize their merger at the end of this month. That's coming up on today's Gist Healthcare Daily.
As a note to listeners, the podcast will be taking a short break this week for the Thanksgiving holiday.
The recently closed merger of UnitedHealth Group and Change Healthcare could be in jeopardy after theDepartment of Justice submitted an appeal to an earlier judge’s decision to allow it to move forward. A coalition of states is calling on CMS to drop its vaccine mandate for healthcare workers. And former Theranos CEO Elizabeth Holmes was sentenced to prison last week. That's coming up on today's episode of Gist Healthcare Daily.
There are significant disparities along racial lines in the orthopedic speciality field. Black patients are 30% less likely to undergo total hip and knee replacements compared to white patients, even though rates of arthritis remain close to the same between the two groups. And those racial disparities extend to the field of orthopedic surgeons with fewer than 2% of Black orthopedic physicians practicing in the United States. On today's episode, Dr. Alonzo Sexton--co-founder and CEO of ATL Orthopedics--joins Gist Healthcare Daily to talk more about his private practice and how it makes orthopedic care more accessible to an underserved community.
Big names in the healthcare and tech world flocked to Las Vegas this week for the fifth annual HLTH Conference. Big tech companies like Google and Uber are looking to take an expanded role in the healthcare industry, government officials want to strengthen public-private partnerships, and more.
Pediatric physicians are urging the Biden Administration to declare a national and public health emergency as respiratory illnesses are leading to a surge in hospitalizations among children. Walmart will pay $3 billion as part of a multi-state opioid lawsuit. And virtual care company Hims & Hers secures another health system partnership. That's coming up on today's episode of Gist Healthcare Daily.
Amazon unveiled its new virtual care platform–Amazon Clinic–which will treat non-urgent consumer health needs. Two large regional health systems in the upper midwest announced they plan to merge in a $14-billion deal. And 21,000 nurses will strike at 21 Kaiser Permanente facilities in California next week. That's all coming up on today's episode o Gist Healthcare Daily.
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The federal COVID-19 public health emergency will likely continue through early April. Moderna released its latest efficacy finding for its updated Omicron booster. And emergency room physicians across the country say that ERs are at the breaking point and are asking for relief from the Biden administration. That's coming up on today's episode of Gist Healthcare Daily.
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It’s been less than a week since voters went to the polls across the country to cast their ballots in the 2022 Midterm Elections. Gist Healthcare leaders–CEO Chas Roades and President Dr. Lisa Bielamowicz–join the podcast today to talk about how healthcare played a role in this year’s election and what we can expect from 2024.
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Physicians at one of the largest teaching hospital systems in New York City announced they are unionizing. Insurtech companies–Bright Health Group and Oscar Health–are scaling back their Medicare Advantage plan offerings. And the Supreme Court signals it won’t gut a law that allows Medicaid recipients to sue over benefits. That's coming up on today's episode of Gist Healthcare Daily.
Healthcare was on the ballot in several places Tuesday - South Dakota became the latest state to expand Medicaid coverage through a ballot measure, abortion access became a driving force at the polls, and a new law in Arizona regulating how collections agencies collect medical debt could set a precedent for other states. That's coming up on today's episode of Gist Healthcare Daily.
Mass General Brigham joins other health systems in adopting a code of conduct for patients. A new study aims to prove–or disprove–the prevailing hypothesis about the cause of Alzheimer’s. And the Center for Medicare and Medicaid Innovation updates its strategy for implementing value-based care. That's all coming up on today's episode of Gist Healthcare Daily.
A group of orthopedic surgeons who broke away from a Wisconsin system are opening a new independent practice - managed by a national private-equity backed chain. After a rough 2022, hospital closures could rise next year. And a new report finds that the commercial insurance market lacks competition in many states. That's all coming up on today's episode of Gist Healthcare Daily.
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Pfizer and BioNTech share promising new data on the efficacy of their bivalent booster, despite smaller studies to the contrary. The CDC reports that nearly 84% of pregnancy-related deaths could be prevented. And a new analysis shows that most Medicare beneficiaries don’t compare plans during the annual open enrollment period. That's coming up on today's episode of Gist Healthcare Daily.
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Physicians groups are gearing up to lobby Congress over pay cuts from CMS. Medicare fines for hospital readmissions declined last year but a number of hospitals were still penalized. And New York and California are hotspots for the new BQ strains of the COVID-19 virus and it could soon spread to the rest of the country. That's coming up on today's episode of Gist Healthcare Daily.
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CMS released its final payment rules for 2023 this week and physician reimbursement is set to decline. An FDA advisory panel found that pulse oximeters may be inaccurate on Black and brown patients. And CVS and Walgreens have agreed to a $10 billion deal to settle thousands of opioid lawsuits brought against them.
Pfizer announced the clinical trial of its bivalent vaccine for RSV was successful in protecting infants from the illness. A merger could be in the works for Summit Health and Walgreens-backed Village MD. And new data show who’s affected most by long-COVID. That's coming up on today's episode of Gist Healthcare Daily.
Open enrollment for the Affordable Care Act insurance marketplace starts today. CVS Health is partnering with a startup to provide customers with more at-home self-diagnostic tests.. And the amount of money spent on health care lobbying has jumped 70% over the last two decades. That's coming up on today's episode of Gist Healthcare Daily.
While the cost of employer-sponsored health insurance didn’t really change between 2021 and 2022, it'll likely increase next year once inflation is factored in. The majority of U.S. states have now expanded their postpartum Medicaid coverage from 60 days to one year. And a new survey finds that nearly half of Americans are in debt due to medical bills. That's on today's episode of Gist Healthcare Daily.
Walmart Health plans to open 16 more health centers in Florida next year. Amazon Pharmacy inks a deal with another Blues plan to deliver prescriptions to beneficiaries. And CMS will restrict Medicare Advantage TV ads next year amid complaints that they are confusing. That’s all coming up on today’s episode of Gist Healthcare Daily.
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The Affordable Care Act’s preventive care coverage could be in legal jeopardy. Digital health funding is cooling after a banner year in 2021. And a new report finds 117,000 physicians left the healthcare workforce last year. That's on today's episode of Gist Healthcare Daily.
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The U.S. Department of Health and Human service is challenging Merck over its non-compliance with the 340B program. Mental telehealth provider Cerebral is laying off 20% of its workforce. And two healthcare providers have announces a new virtual and in-home care company. That’s on today’s episode of Gist Healthcare Daily.
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Two large, publicly-traded hospital systems are reporting a drop in profits. A capitated primary care provider for self-insured employers plans to expand to payer clients. And flu cases are already trending higher this year. That's on today's episode of Gist Healthcare Daily.
Hospitals across the country are being overwhelmed with cases of young children diagnosed with a common respiratory virus. A new report finds a majority of hospitals are now complying with price transparency rules. And new data show a link between COVID-19 and an increase in pregnancy-related deaths in the U.S. That's coming up on today's episode of Gist Healthcare Daily.
An FDA committee has voted to pull a preterm birth prevention drug from the market, which had been approved through its controversial accelerated approval program. A CDC panel recommends providing free COVID vaccines to lower-income children. And a large insurer will now cover some software-based therapies for psychiatric and other conditions. That's on today's episode of Gist Healthcare Daily.
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A new survey shows the widespread impact of the current labor shortage on hospital operations. Walgreens and CVS face a federal probe over allegations that pharmacists refused to fill prescriptions for medications that could harm a pregnancy. And consumers can now purchase hearing aids over-the-counter. That's on today's episode of Gist Healthcare Daily.
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On today's episode of Gist Healthcare Daily: some Medicare Advantage payers may see less revenue after being hit with star ratings downgrades. The US Department of Justice is suing Cigna over allegedly upcoding MA patients via in-home assessments. And Walgreens is looking to acquire a tech asset next.
Telemedicine provider Babylon Health has announced plans to sell its California IPA business. Providence is being investigated in Oregon for consumer protections violations stemming from its financial and billing practices. And two midwest healthcare systems are investigating a possible merger. That’s all coming up on today’s episode of Gist Healthcare Daily.
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One of the largest hospital chains in the United States confirmed that it was the target of a ransomware attack. A new study is casting doubt about the efficacy of colonoscopies. And a major insurtech company is drastically reducing its presence in the marketplace. That’s all coming up on today’s episode of Gist Healthcare Daily.
Note: this episode has been updated to clarify a statistic in the colonoscopy study story.
The migration of procedures away from hospital inpatient departments preceded the pandemic, but COVID accelerated that shift. This is most obvious among orthopedic procedures like hip and knee replacements. Gist Healthcare partnered with Stratasan, a Syntellis-owned healthcare data analytics firm providing market intelligence for strategic planning, to quantify how much much knee and hip replacement procedure volume is moving outpatient. A detailed infographic about this shift will be published on GistHealthcare.com later today. Stratasan's Senior Product Manager Michael Shipley joins the podcast to discuss the findings of the data analysis, where the volume is migrating, and how this impacts hospital systems.
This is host Alex Olgin's last podcast episode. The podcast will be taking a break as we hire and train a new host, but we're planning to be back with new episodes in September.
On this episode of Gist Healthcare Daily, federal health officials adopt a new monkeypox vaccine strategy to stretch doses. TikTok parent company, ByteDance, acquires a Chinese hospital chain. And US hospital CEO's are leaving their positions at high rates.
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On this episode of Gist Healthcare Daily, hospitals in states with strict abortion laws struggle to recruit physicians. CivicaScript starts selling its first outpatient generic drug to treat prostate cancer. And a new study published in Nature Climate Change finds climate change is exacerbating some infectious diseases.
On this episode of Gist Healthcare Daily, the Senate passes a bill with major reforms for seniors on Medicare. A new NPR, the Robert Wood Johnson Foundation, and Harvard TH Chan School of Public Health poll finds a fifth of sick patients weren’t able to get necessary medical care. And there are rumors that CVS is interested in acquiring Signify Health.
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On this episode of Gist Healthcare Daily, Kansas voters rejected a ballot measure that would have overturned a constitutional right to abortion. Medicare raises payment rates for hospitals next year. And the highly consolidated dialysis industry could spell problems for Medicare Advantage plans.
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In this episode of Gist Healthcare Daily, the trial challenging UnitedHealth Group’s acquisition of Change Healthcare starts this week. Hospitals look beyond pay to retain employees. And New York alleges CVS Health of preventing hospitals from obtaining 340B discounts.
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Earlier this month, Morgan Health invested $30M in Centivo, an innovative health plan for self-insured employers. In this episode, we hear from Dan Hartman, Executive Director at Morgan Health, and Ashok Subramanian, CEO of Centivo, about how Centivo plans to leverage the Morgan investment to expand its services.
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On this episode of Gist Healthcare Daily, Democrats reach a deal on a healthcare and climate bill. More than 40 percent of parents of kids under 5 say they won't get their child vaccinated for COVID-19. And after years of sky high travel nurse wages, the market is starting to return to normal.
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On this episode of Gist Healthcare Daily, the Biden Administration reinstates and expands Affordable Care Act nondiscrimination protections. In a rare move, nurses at a Mayo Clinic hospital decertify their union. And the White House estimates it could cost up to $7B to adequately respond to the growing monkeypox outbreak.
On this episode of Gist Healthcare Daily, a challenge to the Affordable Care Act's preventive care requirement is in front of a Texas federal court. Hospitals are still struggling to rein in labor costs. And the Wall Street Journal takes the latest look at how nonprofit hospitals lag on charity care.
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On this episode of Gist Healthcare Daily, a challenge to the Affordable Care Act's preventive care requirement is in front of a Texas federal court. Hospitals are still struggling to rein in labor costs. And the Wall Street Journal takes the latest look at how nonprofit hospitals lag on charity care.
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On today's episode of Gist Healthcare Daily, providers await Medicare’s plan to remedy 340B reimbursement cuts. The White House is revamping its booster strategy. And racial disparities persist across insurance coverage.
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In this episode, Gist Healthcare co-founders Chas Roades and Lisa Bielamowicz discuss how the deteriorating economy and increased margin pressures are creating significant challenges for health systems.
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Amazon announces plans to acquire concierge primary care company One Medical for $3.5B. President Biden tests positive for COVID and is reporting mild symptoms. And health systems are feeling the pain of at least 18 drugmakers' restrictions on 340B discounts to contract pharmacies.
On this episode of Gist Healthcare Daily, Apple lays out its health strategy. Health costs and inflation are driving premium increases for individual market plans. And the story of how one health plan addressed racial disparities in medication adherence.
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Morgan Health announces its next investment, $30M in Centivo. Even with a vaccine, experts believe we missed the opportunity to contain Monkeypox. And as Kaiser Health News reports, California’s special Medicaid contract with Kaiser Permanente is now official, though several details are missing.
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On today's episiode, Medicare proposes a pay bump for hospital outpatient services, but the American Hospital Association says it’s not enough. The nation's top infectious disease official Dr. Anthony Fauci says he plans to retire by the end of Biden’s first term. And amid a rise in antibiotic-resistant infections, companies aren’t investing in new antibiotics.
In this episode, Will Schpero, Ph.D., a health economist, and assistant professor in the Division of Health Policy and Economics at Weill Cornell Medical College discusses how the new requirement for Medicaid programs to cover the routine costs of clinical trials presents an opportunity to greatly improve diverse patient representation in cutting-edge clinical research.
On today's episode of Gist Healthcare Daily, The COVID-19 vaccine from Novavax finally gets the green light for adults. Rural hospitals are skeptical of a new plan meant to help them keep their doors open. And there's been a flurry of federal action to protect reproductive healthcare access this week, with the latest action targeting pharmacists.
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On today's episode of Gist Healthcare Daily, hospitals push back on a new city of Los Angeles-mandated 25-dollar healthcare worker minimum wage. During covid, superbugs have thrived. And it costs almost $19,000 on average to have a baby in the US.
The White House wants to expand booster shot eligibility to all Americans. Health officials tell hospitals that the federal emergency care law preempts state abortion laws. And this weekend the country’s national mental health hotline, 988, is set to launch.
California plans to make its own insulin. Despite new protections, patients are still getting surprise bills. And Medicare announces changes to the shared savings program.
Vaccine makers are tossing tens of millions of doses in the trash as demand plummets. A new wrinkle in the battle between e-cig maker Juul and the FDA. And how substandard hospital gowns are leaving healthcare workers vulnerable to infection.
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Senate Democrats reach a deal on legislation to lower drug prices. Insurers are reportedly considering acquisitions of primary care companies. And pharmacists can now prescribe Paxlovid.
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In a bid to keep rural hospitals open, the Centers for Medicaid and Medicare Services proposes some can apply for a new status that allows them only to provide outpatient care. Insurers selling coverage on the Affordable Care Act exchanges denied 18 percent of in-network claims in 2020. And a federal judge finds drug distributors aren’t liable for the opioid crisis in West Virginia
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It’s insurers’ and employers’ turn to be transparent about healthcare prices. Democrats are scrambling to extend discounted insurance premiums before midterms. And the federal government launches a targeted vaccine campaign to contain the monkeypox outbreak.
A panel of experts recommends updated COVID vaccine boosters with protection against Omicron variants. Medicare unveils the next iteration of its oncology payment model. And cancer patients say they’re bombarded with ads for unproven treatments on Facebook.
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On this episode, we have a wrap-up of the recent healthcare-related Supreme Court decisions. The federal government is reminding insurers that they are required to cover contraceptives, and retail pharmacies are limiting purchases of Plan B pills.
Providers report confusion after Friday’s Supreme Court ruling overturning Americans’ constitutional right to abortion. Colorado gets federal dollars to implement a public insurance option. And younger nurses are leaving the workforce, driving healthcare workforce shortages.
This month, two groups of hospital-employed physicians in Oregon filed to join a union this month. In this episode, we hear from some of those doctors, as well as Mollie Skov-Ortega, MD, president of a long-standing hospitalist union.
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A Deloitte analysis highlights the shocking cost of healthcare inequality. Americans are looking to Canada for hope in the fight against ALS. And a new report from North Carolina details how unevenly COVID relief funds were distributed to hospital systems.
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In the absence of stronger federal consumer protections for medical debt, states consider new measures. The Markup's investigation reveals that dozens of hospitals inadvertently allowed Facebook to obtain patient information through an embedded tracking tool on their websites. And another hospital deal bites the dust.
A new study finds Medicare could save $3.6B if it bought generic drugs through Mark Cuban’s new pharmacy. Walgreens launches its new clinical trial business. And home health providers are unhappy with Medicare’s planned rate cut.
In this episode, Nigel Ohrenstein, president of the digital musculoskeletal startup Kaia Health says he expects that digital physical therapy will become the default form of physical therapy in the future.
The FTC is investigating whether Cerebral used deceptive business practices to market its mental health services. Kaiser Health News reports on the quick downfall of two Missouri hospitals purchased by a private equity-backed firm. And hospitals are facing new competition for employees - Amazon. A Gist Healthcare, analysis finds more than a quarter of hospital workers are working jobs that pay a lower median wage than Amazon warehouses.
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The Supreme Court sided with hospitals in a dispute about Medicare reimbursement for medications acquired through the 340B discount program. The FDA’s panel of vaccine experts recommends the agency greenlight covid shots for the youngest kids. And New Jersey RWJBarnabas Health abandons plans to acquire Saint Peter's Healthcare after the FTC challenged the deal.
The AMA takes its strongest stance on reproductive rights during its annual meeting this week. Democrats are urging federal lawmakers to extend insurance subsidies. And HCA Healthcare expands its nursing school with a new campus in NC.
Arnold Ventures is funding the latest spate of consumer and employer lawsuits against hospitals for using market power to raise prices. The CDC lifts the covid testing requirement for international travelers. And the FTC asks UnitedHealth Group for more info about its bid to buy LHC Group.
In this episode, we hear from Vijay Yanamadala, MD, a neurosurgeon at Hartford HealthCare and Chief Medical Officer of virtual physical therapy company SWORD Health who estimates at the majority of patients referred for physical therapy could benefit from receiving support virtually.
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The first hospitals are fined for not complying with price transparency rules. The White House announces plans to distribute COVID vaccines for kids under 5. And an overview of what policies are at risk when the federal public health emergency ends.
The Federal Trade Commission launches a probe into Pharmacy Benefit Managers. Oracle completes its $28.4B acquisition of Cerner. And mental health carve-outs can complicate physicians’ ability to provide mental health care.
Nearly three-quarters of nursing homes are concerned about closure. Startup digital health companies announce layoffs. And the FTC sues to block two hospital mergers.
In this episode, we’ll hear from Laura Kwako, PhD, a clinical psychologist at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and Katharine Bradley, MD, a senior investigator at the Kaiser Washington Health Research Institute. The NIAAA just released a Core Resource on Alcohol for healthcare professionals to help providers screen and treat patients for alcohol use disorder, as addiction and alcohol-related deaths have spiked during the pandemic.
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Two physician groups in Oregon announce plans to unionize. And in a first, a woman receives a 3-D printed ear implant made of her own cells.
In a horrific attack, a former patient kills his physician and at least three others at a Tulsa hospital building. Pfizer and BioNTech ask the FDA to approve its COVID vaccine for kids under 5. And UnitedHealth's Optum is reportedly acquiring another Texas medical group.
Miami, Florida-based CareMax, a value-based care company, is acquiring Dallas-based Steward Health Care System’s Medicare value-based care business. In response to the recent mass shootings in Uvalde, Texas, and Buffalo, New York, Kaiser Permanente is establishing a Center for Gun Violence Research and Education. And a new study published in JAMA Internal Medicine finds pulse oximetry devices, which are less accurate at measuring blood oxygen levels in patients of color, may have led to delayed covid care.
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CVS launches a virtual primary care service for Aetna and Caremark members. Medicare Part B premiums will stay flat, despite the agency’s decision to limit coverage of controversial and expensive Alzheimer's drug Aduhelm to beneficiaries in clinical trials. And the American Medical Association opposes a bill that would require training on opioid use disorder treatment.
Experts are stumped about a recent pediatric hepatitis outbreak. The FDA tries to redefine the word “healthy” as it considers adding a new label to food that meets federal dietary guidelines. And long-lasting injectable drugs can help treat addiction and mental illness— but the price tag is steep.
The formula shortage lands two children in the hospital. The insurance industry calls for more transparency on private equity healthcare deals. And states pass laws preventing how hospitals can alter visitor policies.
Humana expands its senior-focused primary care clinics through a new joint venture with a private equity firm. Kaiser Health News reports state and local health departments are slow to spend federal COVID relief dollars aimed at reducing health disparities. And the FDA approves the first at-home test for multiple respiratory viruses.
The Biden Administration plans to extend the public health emergency this week. The Tennessee nurse convicted of negligent homicide for a fatal medication error is sentenced to three years’ probation. And federal and state scrutiny of non-compete agreements increases.
In this episode we hear from Elaine Batchlor, MD, CEO of MLK Community Healthcare and the systems flagship hospital MLK Community Hospital in South Los Angeles. She discusses the challenges the safety net hospital is facing as it emerges from the COVID pandemic.
The Justice Department is investigating mental health startup Cerebral for violations of the controlled substances act. Pandemic delays in cancer screenings are leading to patients with more advanced disease. And drug overdose hit a record high of nearly 108,000 in 2021.
North Carolina-based Atrium Health announced plans to merge with Midwest behemoth Advocate Aurora Health. There’s a shortage of a key dye used in healthcare imaging, leading some systems to limit scans to emergency patients. And the days of travel nurses making $10,000 a week are dwindling.
Healthcare workers strike and join unions across California. Attempts to repeal South Carolina’s certificate of need law stall out. And loss of pandemic aid hurts safety-net hospitals.
As labor costs rise, hospitals turn to insurers for rate increases. White House officials are forecasting another large covid surge this winter. And Banner Health doubles down on plans to grow its ambulatory surgery center footprint with an investment in Atlas Healthcare Partners.
This episode explores the drivers of private equity’s growing interest in cardiology practices in a conversation with consultant Anthony D’Eredita, Founder and CEO of TrustWorks Collective, and Dan Blumenthal, MD, CEO of PE-backed cardiovascular care delivery platform Novocardia.
Hospitals are taking a bigger financial hit as the number of drugmakers restricting 340b discounts doubles. A record nearly 36 million people have insurance through Affordable Care Act coverage pathways. And more than two years later hospital volumes still haven’t returned to pre-pandemic levels.
The FDA says there’s "no evidence" that doubling an individual’s dose of Paxlovid will reduce the return of COVID symptoms. Mental health telemedicine company Cerebral stops prescribing Adderall to new patients as the company faces increasing scrutiny for its marketing and prescribing practices. And a Health Affairs study finds several physicians in insurers’ Medicaid networks aren’t seeing patients.
If the leaked Supreme Court abortion decision is finalized, medical training for the procedure could become limited for nearly half of obstetrics and gynecology residents. In Illinois, a private equity-backed physician group gets state approval to build a hospital in Quincy. And after Medicare’s decision to restrict coverage of Alzheimer’s drug Aduhelm, Biogen searches for a new CEO.
Officials are looking into growing reports of the so-called Paxlovid rebound. Medicare Advantage plans are denying care and payment that traditional Medicare covers. And health officials say it’s unlikely COVID or the vaccine is related to the mysterious hepatitis cases.
Houston-based Memorial Hermann Health System embarked on a plan to reorganize the system around service lines a little over two years ago. In this episode, the two senior vice presidents of service lines who led the effort, Kyle Price and Heath Rushing, discuss how the system shifted from being organized around hospitals to instead being organized around product lines.
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Concert Health CEO Spencer Hutchins discusses how the San Diego-based behavioral health medical group works in tandem with primary care providers to treat patients with behavioral health needs.
This episode was originally published in May 2021.
Although the center of excellence model has been around for years, it has been mainly used by mega-employers. San Francisco-based Carrum Health is making this more accessible to smaller companies through its digital marketplace that connects self-insured employers with a network of providers.
This episode was originally published in September 2021.
As the country struggles with a shortage of inpatient behavioral health beds and mental healthcare providers, health systems are increasingly turning to telepsychiatry to meet the need. Geoffrey Boyce, CEO of Array Behavioral Care, a 23-year-old telepsychiatry group, says that health systems are seeking more comprehensive behavioral health solutions across inpatient, virtual and home-based settings, but regulatory barriers are standing in the way of more widespread adoption.
This episode was originally published in January 2022.
Virginia-based Privia Health, one of a growing number of high-profile “physician enablement” firms that helps practices improve operations and transition to value-based care delivery, held its initial public offering last May. CEO Shawn Morris discusses how the company plans to grow.
This episode was originally published in May 2021.
Janelle Lee, VP of Talent Services at St. Joseph, MO-based Mosaic Life Care, discusses strategies to bolster nurse retention during the COVID crisis. In addition to financial incentives, Mosaic is allowing shift flexibility and increasing training and support for first-year nurses.
This episode was originally published in January 2022.
Almost three-quarters of the nation's physicians are employed by health systems, insurers, or other corporate entities. A new study finds some cancer hospitals drastically mark up drug prices. And the CDC announces a new team to forecast outbreaks of the coronavirus and other diseases.
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Most hospitals say keep your masks on. Health insurers in California oppose the state’s plan to give Kaiser a no-bid Medicaid contract. And hospitals call the proposed Medicare inpatient pay increase inadequate.
Optum Health raises projections for growth in value-based care arrangements. Digital health funding slows after several consecutive quarters of record-breaking investment. And the Supreme Court decides not to hear a case challenging Medicaid work requirements.
A federal judge in Florida strikes down the federal mask mandate for planes, trains, and other public transit. Bright Health is fined by the Colorado Department of Insurance after it fails to complete basic health plan tasks. And a jury acquitted a former DaVita CEO of criminal charges related to no-poach agreements with competitors.
CVS Health has moved quickly to build out its new clinical trial services unit since its launch, announcing a partnership with decentralized clinical trial software platform Medable and opening up research sites around the country. General Manager of CVS Clinical Trial Services Tony Clapsis discusses the unit's growth and plans to build a nationwide research network.
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A new analysis finds that most nonprofit health systems spend less on community benefits than the value of their tax breaks. Nurse Practitioners will be able to practice independently in New York. And in Illinois, there's a fight between a private equity-backed physician group seeking to build a new hospital and a local health system.
The White House announces plans to tackle medical debt by probing providers' billing and collection practices. The Centers for Medicare and Medicaid Services advances plans to establish staffing requirements at nursing homes. And healthcare workers at several health systems in California authorize strikes.
Hospital deal activity slowed in the first quarter of this year. Refurbished medical equipment helps fill gaps in supply. And the City of Philadelphia and several universities reinstate mask requirements as COVID cases rise in half of states.
In this episode, we bring you a conversation with Dan Mendelson, CEO of Morgan Health. Dan discusses recent investments in Vera Whole Health and Embold Health, an upcoming primary care pilot in Columbus, Ohio, and areas the venture is looking to invest in next.
Walgreens provides opens dozens of Health Corners to provide more in-store care. Medicare limits coverage of the new Alzheimer’s drug to participants in clinical trials. And a National Academy of Sciences report calls for action on reforming the country’s broken nursing home care system.
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UnitedHealth Group's Optum makes a play to buy a large Houston area multispecialty group. Millions have left their jobs to care for aging family members. And an FDA advisory panel discusses the agency's COVID booster strategy.
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Walmart opens five health clinics in Florida. President Biden announces plans to fix the family glitch. And Salt Lake City-based Intermountain Healthcare and Broomfield, Colorado-based SCL Health officially complete their merger.
Senators reach a $10B COVID funding compromise. Medicare is now covering over-the-counter covid tests. And funding for virtual behavioral health tools geared towards kids takes off.
Over the last few years, momentum has been growing to repeal Certificate of Need (CON) laws, currently in effect in 35 states. In this episode Matthew Mitchell, Senior Research Fellow at the Mercatus Center at George Mason University discusses the catalysts and effects of CON reform.
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An alarming number of primary care doctors say they are planning to leave practice. States are expanding pharmacists' role in patient care. And despite new surprise billing protections, patients are still concerned about the bills according to a new Kaiser Family Foundation survey.
President Biden presses Congress to authorize more COVID relief funding after receiving his second booster on live television. Physicians continue to leave HCA Healthcare-owned Mission Health in Western North Carolina. And amid medical supply shortages, people with chronic illnesses struggle to get equipment.
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UnitedHealth Group’s health services unit, Optum, announced plans to buy the home health, hospice, and long-term acute care hospital company LHC Group for $5.4B. The Food and Drug Administration expands authorization of fourth shots of the Pfizer and Moderna COVID vaccines for adults 50 and older. And rising supply and labor costs combined with people returning for delayed care are expected to increase healthcare spending this year.
A Tennessee nurse is convicted of negligent homicide after a fatal medication error. Cleveland Clinic’s new 184-bed London hospital will start seeing new patients as early as this week. And 16 drugmakers are now limiting discounts to safety-net hospitals in the 340B program.
Six large health systems recently announced the launch of Evolve Health Alliance, a new collaboration to address workforce challenges and share insights from their respective systems. In this episode, Matt Kurth, Deputy Chief People Officer at Northwell Health, one of the alliance’s founding members, will discuss how the partner systems plan to work together.
A new study builds on evidence of a link between covid infection and diabetes. States raise penalties for threats of violence against healthcare workers. And healthcare data breaches reached an all-time high in 2021.
Moderna plans to ask regulators to greenlight its COVID vaccine for kids six months to under six years old. Contributing to hospitals filling nursing vacancies, state nursing boards are slow to approve new licenses. And new sickle-cell gene therapies are showing promising results, the next struggle will be getting patients to accept them.
The criminal trial of a Tennessee nurse who committed a fatal medication error begins. Starting next month hospitals will no longer be reimbursed for caring for uninsured COVID-19 patients. And hospitals and states renew scrutiny on rising hospital prices.
The three largest credit companies are changing how they report medical debt. Fresenius, InterWell Health, and Cricket Health create a new kidney care company. And health officials expect COVID cases of the omicron sub-variant to start rising.
In this episode, we hear from Dr. Taki Michaelidis, Medical Director of the UMass Memorial Health Hospital at Home Program. The Worcester-based system has quickly scaled up its program, doubling capacity in just a few months.
This episode was originally published in December 2021. hin
The White House taps Dr. Ashish Jha to replace Jeff Zients as White House COVID response coordinator. As many as 16 million people risk losing Medicaid coverage when eligibility checks resume. And a Harvard Business review article makes the case for collaboration in healthcare.
Pfizer and BioNTech ask regulators to approve a fourth COVID vaccine dose for seniors. And retail and primary care disruptors want to partner with health systems. And the pandemic continues to accelerate the shift from inpatient to outpatient care.
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Without more funding, the White House says it will run out of money to buy new covid treatments. Americans are less likely to have primary care doctors than patients in other high-income countries. And a government watchdog warns it’s time to get Medicare Advantage spending in check.
Americans’ $195 billion medical debt burden is unevenly distributed. And six health systems join together to address workforce challenges. And a jury in Northern California finds that Sacramento-based Sutter Health did not use its market power to engage in anticompetitive contracting practices.
Americans’ $195 billion medical debt burden is unevenly distributed. And six health systems join together to address workforce challenges. And a jury in Northern California finds that Sacramento-based Sutter Health did not use its market power to engage in anticompetitive contracting practices.
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In the final episode in our series about healthcare platforms, we’ll hear from Seth Joseph, managing director at consulting firm Summit Health. Despite the common perception that platform businesses are overnight success stories, he says actually been a slower road for most to gain traction and realize growth.
In the final episode in our series about healthcare platforms, we’ll hear from Seth Joseph, managing director at consulting firm Summit Health. Despite the common perception that platform businesses are overnight success stories, he says actually been a slower road for most to gain traction and realize growth.
Nurses take their labor grievances to Washington. Delaware has success in narrowing racial disparities in cancer care with patient navigators. And why one industry is still doing business in Russia even after the invasion of Ukraine.
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Nursing home groups push back against plans to establish minimum staffing levels. Congress reaches a spending deal but it doesn’t include any more covid response funding. And as we approach one million COVID deaths in the US, we are becoming numb to the number.
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One study finds more expensive emergency care can lead to better outcomes in competitive hospital markets. Amazon and Teladoc are partners to allow consumers to get audio visits through smart speakers. And experts unveil a plan for the country to move to the “next normal”.
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The American Medical Association criticizes Biden’s test-to-treat COVID program. Healthcare employment jumped in February, yet it’s still below pre-pandemic levels. And Civica announces plans to manufacture low-cost insulin.
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On the third episode in our series on the growing popularity of the platform strategy, we hear from Derek Streat, CEO of health tech company DexCare. The Providence spinout is now offering its digital operating system to other health systems to help connect point solutions.
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The justice department files suit to block UnitedHealth Group’s acquisition of Change Healthcare. Maternal mortality increased sharply during the first year of the pandemic. And a New Yorker piece highlights how the changing demographics of physicians are altering the American Medical Association's priorities.
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COVID vaccine mandates didn’t lead to an exodus of healthcare workers as feared. States look to Washington State as they consider public option plans. And ground ambulances have swelled over the last few years, according to a new report from FAIR Health.
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The federal government steps up challenges to healthcare mergers. Dr. Paul Farmer, a public health giant, dies at age 62. And health systems are anxiously awaiting to see how Medicare will pay for hospital care at home.
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In the second episode in our platform series, Gist Healthcare co-founders Chas Roades and Lisa Bielamowicz discuss how health systems are vertically integrating to create care ecosystems to build consumer loyalty and fend off competition from disruptors.
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The Federal Trade Commission declines to investigate PBMs. Rising labor and supply costs eat into hospitals operating margins. And provider groups push back against canceling Medicare's DIrect Contracting payment demonstration.
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Vaccine mandate deadlines hit for healthcare workers in half the country this week. Robert Califf is confirmed to lead the FDA. And as the demand for nurses remains high, so does investment in staffing firms.
Vaccine mandate deadlines hit for healthcare workers in half the country this week. Robert Califf is confirmed to lead the FDA. And as the demand for nurses remains high, so does investment in staffing firms.
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In yet another twist, the FDA delays its review of COVID vaccines for young kids. Republicans call for the end of the public health emergency. And Signify Health acquires Caravan Health.
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This episiode is the first in a four-part series on the growing popularity of the “platform” business model in healthcare, and what it might mean for the industry. In this episode consultants Vince Kuraitis and Dr. Randy Williams, who advise healthcare companies on platform strategy, about the current state of the market.
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A new study finds COVID increases the risk of heart disease. A year later and most hospitals still aren’t complying with price transparency rules. And this week there were more mixed messages about whether to rip off our masks.
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CVS partners with Medable to expand clinical trial services. Digital health company Thirty Madison buys Nurx. And hospital CEOs say their top concern is labor shortages.
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Medicare is simultaneously rewarding and penalizing hospitals for patient safety and quality of care. Amazon Care plans to expand into 20 cities this year. And with Biden’s Chief science advisor resigning, three scientific and medical agencies are without permanent leadership.
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Kaiser Permanente secures a no-bid California Medicaid contract. Governors in the Northeast say school mask mandates will soon end. And direct to consumer health companies are sharing data with third-party sites.
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Pfizer is reportedly joining 12 other pharmaceutical companies in limiting 340B discounts to hospitals contracting with pharmacies to distribute medications. This episode details the saga between pharmaceutical companies and hospitals over the 340B program which has come under scrutiny in recent years. Hospitals say the drugmakers move to limit discounts and Medicare's decision to cut reimbursement are cutting into savings used to fund charity care and specialty pharmacy programs.
This episode is a rerun and was originally published in November of 2021.
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Senators work on a bipartisan package to address the country’s growing mental health crisis. The travel nursing industry defends itself after accusations by hospitals of price gouging. Medicare is out with a plan to provide free COVID tests over the counter.
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President Biden revives his cancer moonshot plan to cut the death rate in half over the next 25 years. Anthem is staying the course on its partner not acquire strategy. And reaching the point where covid becomes endemic - is far from the end.
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Pfizer and BioNTech are asking the Food and Drug Administration for emergency use authorization of their two-dose covid vaccine for kids under 5-years-old. Michigan health systems Beaumont Health and Spectrum Health are moving forward with their planned merger. Multiple states ask CMS for more flexibility in enforcing the COVID vaccine mandate for healthcare workers.
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The FDA fully approves Moderna’s covid vaccine. South Carolina is the latest state looking to scrap certificate of need laws. And there’s reported tension between the White House and the Secretary of Health.
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As the country struggles with a shortage of inpatient behavioral health beds and mental healthcare providers, health systems are increasingly turning to telepsychiatry to meet the need. Geoffrey Boyce, CEO of Array Behavioral Care, a 23-year-old telepsychiatry group, says that health systems are seeking more comprehensive behavioral health solutions across inpatient, virtual and home-based settings, but regulatory barriers are standing in the way of more widespread adoption.
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A record 14.5 million people signed up for individual market plans in 2022. Suicide attempts are up but the number of people seeking mental healthcare has remained flat. And STAT News reporting federal provider relief funds were used for covid drugs and vaccines.
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Massachusetts General Brigham will need to come up with a plan for how to reduce its high spending. New research sheds light on factors that may lead patients to develop long COVID. Former North Carolina Secretary of Health Dr. Mandy Cohen will join primary care enablement company Aledade.
The American Hospital Association is pleading for government help with staffing shortages. Many health plans still aren’t complying with mental health parity rules. And Uber hires a chief medical officer.
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As US hospitals recruit nurses from overseas, the countries they leave behind struggle with shortages. Traditional Medicare beneficiaries are excluded from new at-home covid test coverage. And IBM sells its Watson Health assets to a private equity firm.
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Dr. Wes Ely, a pulmonology and critical care physician at Vanderbilt University and co-director of the Critical Illness, Brain Dysfunction and Survivorship Center, says while much of the current COVID focus is on acute infection, health systems must prepare to care for the millions of chronically disabled individuals with “long COVID.” Dr. Ely's research focus is on cognitive issues that ICU patients develop during or after their stays, some of which appear similar to long covid. Ely wrote about his efforts to reform intensive care in his newly released book, "Every Deep-Drawn Breath".
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A new Health Affairs study finds racial bias in patient notes. There are drugs being developed to treat Obesity, but a big hurdle getting providers to recognize it as a disease. And in some places, COVID appears to be receding as quickly as it surged.
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How much progress has President Biden made on his efforts to defeat the pandemic in his first year? A few weeks into 2022, digital health company Babylon Health already announced two acquisitions. And even though the US has two highly effective COVID antiviral medications, supplies are scarce and incredibly challenging to get.
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Americans can now get free rapid covid tests sent right to their homes. Now that the Supreme Court has allowed the vaccine mandate for healthcare workers to proceed, hospitals have to reinstate requirements. And new research finds a link between the Epstein-Barr virus and multiple sclerosis.
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In the first conversation of the year Gist Healthcare co-founders, Chas Roades and Lisa Bielamowicz discuss the healthcare trends they're watching for 2022, including the next phase of the COVID pandemic, the challenge of rising labor costs, surging investment in digital health, and the shifting demographics of Medicare.
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The Supreme Court rules the vaccine requirement for healthcare workers can go forward in facilities that receive Medicare and Medicaid reimbursement. This Omicron wave is particularly hard for parents of kids 5 and under who can’t get vaccinated. And primary care enablement company Aledade acquires advanced care planning company Irish Healthcare.
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Insurers lower Medicare Advantage projections amid a hyper-competitive market. More people are turning to at-home tests as backlogs for care grow. And it’s time to ditch the cloth masks and don an N95 or KN95.
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If you’re lucky enough to find an at-home COVID test, private insurers will soon be required to pay for it. Medicare decides to only cover Biogen’s controversial Alzheimer’s drug for a subset of patients in clinical trials. And Omicron is forcing millions to call out sick.
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After Biogen halved the price of its Alzheimers drug Medicare reevaluates its Part B premium hike. Omicron’s deluge on hospitals could be even worse than what’s being reported. And six former White House COVID advisors call for a new covid strategy.
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Janelle Lee, VP of Talent Services at St. Joseph, MO-based Mosaic Life Care, discusses strategies to bolster nurse retention during the COVID crisis. In addition to financial incentives, Mosaic is allowing shift flexibility and increasing training and support for first-year nurses.
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The Supreme Court will hear oral arguments on vaccine mandates today. The American Medical Association blasts the CDC’s COVID isolation guidance. With the new year, pharmaceutical companies have raised list prices on drugs an average of 5 percent, according to industry reports.
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Nursing home staff shortages are having cascading impacts on hospitals. Seattle-based Primary care company Vera Whole Health and San Francisco-based health navigation company Castlight Health announce plans to merge. And UnitedHealthcare confirms it’s not implementing a controversial ER coverage policy.
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A jury finds the founder of Theranos guilty on four counts of fraud. Biden’s plans to increase testing and antiviral drugs will come too late for the current surge. And large for-profit hospital chains’ expansion strategies shift to outpatient sites.
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As we enter the third year of the COVID pandemic, hospitals are again struggling to deal with an influx of patients. Oracle announces plans to buy Cerner. And the surprise billing ban went into effect on January 1.
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As COVID cases climb, companies return to remote work and schools go online. Physician practice acquisitions fuel the big surge in healthcare deals this year. And there are big regional variations in child covid vaccine uptake.
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A third of Americans say they’re skipping at least some healthcare because it’s too expensive. The $35 monthly cap on insulin faces a challenge in the Senate. And the US passes another grim threshold, 800,000 COVID deaths.
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Employer health benefits costs rose faster this year than in any year since 2010. A record 19 rural hospitals closed in 2020, but more are joining forces with larger systems. And signs from Europe and Africa spell trouble for Omicron’s spread in the US.
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Companies are overwhelmed by all the new healthcare startups targeting specific conditions. Elizabeth Mitchell, CEO and President of the Purchaser Business Group on Health, which represents large employers buying health benefits, says companies are looking for an integrated solution and independent information about efficacy.
Today's episode is a rerun and was first published in August.
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As health plans look to lower the cost of care for growing Medicare Advantage populations, they’re investing in for profit primary care companies that are also addressing social needs. On this episode Dean Emeritus of the Jefferson College of Population Health Dr. David Nash says amid a flood of investor capital, it’s important to evaluate the social return.
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The American Hospital and Medical Associations challenge the arbitration provision of the surprise billing ban. And we go to France where vaccine passports, which will soon require 3 shots, are necessary to do almost anything in public.
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LA area cancer organization City of Hope announces plans to buy Cancer Treatment Centers of America. Cigna invests in insurtech startup BrightHealth. And the House passes legislation to avert Medicare cuts.
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A new study in Health Affairs shows nonprofit Wisconsin hospital lawsuits against patients increased 37 percent between 2001 and 2018. There's more mandate mania, as New York City announces a COVID vaccine requirement for private companies. And Uber is bringing healthcare to consumers on demand.
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Medicare beneficiaries used 6000% more telehealth in 2020 than pre-pandemic. While the attention is on Omicron, Delta is what hospitals are still worried about right now. And Physicians Assistants’ recent title change to Physician Associates isn’t sitting well with doctors.
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President Biden will require private insurers to pay for at-home covid tests. CVS and Microsoft expand their partnership to digitize and personalize care. And a tale of two states that expanded Medicaid with dramatically different outcomes.
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As omicron cases are identified across the globe, countries are scrambling to prevent a surge in cases. Germany, Greece, and Austria are imposing restrictions on the unvaccinated. The US and UK are turning to booster shots. Earlier this week British Prime Minister Boris Johnson said he plans to make boosters available to all adults by the end of January. In this episode, Maya Kroth reports from London.
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A new ruling extends the pause on healthcare worker vaccine mandates nationwide. The first case of the omicron variant is found in California. And we recap the Supreme Court arguments in the case challenging whether Medicare can cut drug payments to some hospitals.
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A Las Vegas jury finds UnitedHealthcare has been underpaying TeamHealth physicians in Nevada. The CDC is searching for cases of the omicron variant in the US. And HCA Healthcare expands its Florida footprint.
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President Biden says the omicron variant is a cause for concern but not panic. A judge temporarily blocks the vaccine mandate for healthcare workers. And an experimental treatment appears to have cured a man of Type 1 diabetes.
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A jury rules finds CVS, Walgreens, and Walmart pharmacies recklessly distributed opioids. The Biden administration releases $7.5 billion in relief funding for rural providers. And consumers are dealing with a patchwork of telehealth coverage.
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All the single-use PPE is creating a huge medical waste problem. Two private equity firms buy AthenaHealth. And there’s a small window for patients to get the benefits from the new coronavirus antiviral pills.
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The CDC clears booster shots for all adults. The House passes the $1.75 trillion spending plan which includes several healthcare reforms. And physicians accuse a large Lasik eye surgery chain of pressure to boost volumes.
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As CVS Health repositions itself to provide more primary care, the company announces plans to close 900 stores. About a third of healthcare workers aren’t vaccinated. And doctors have had enough with their peers spreading covid disinformation.
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The former Sanford Health CEO left the system with a $49 million golden parachute. Lawmakers say the new surprise billing dispute resolution rule isn’t what they intended. And the partisan divide about vaccines seems to go beyond the coronavirus.
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Austria introduces a lockdown for the unvaccinated. Dealing with hostile patients and feeling unsupported by employers are just a few of the factors driving doctors and nurses to leave healthcare. And a STAT News investigation looks into Ascension private equity operation.
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Kaiser Permanente reached a deal with unions to avoid massive strikes. Medicare hasn’t even decided to cover an expensive new Alzheimer's drug yet, and it’s already driving premium increases. And finally, President Biden has chosen a nominee to lead the FDA.
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This fall payers like UnitedHealthcare, Cigna, and Aetna all launched virtual first primary care plans this fall. In this March 2021 conversation, Gist Healthcare co-founders, Chas Roades and Lisa Bielamowicz discuss how insurers are integrating their new care offerings to capture more of consumers' healthcare spend.
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Dr. Farzad Mostashari, CEO and co-founder of Aledade, discusses how quality reporting for physicians has become time-intensive and no longer commensurate with incentives. He tells us the whole system is in need of “radical surgery”.
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In the final episode of our series exploring investor acquisitions of physician practices, we’ll look at the hospital-based physician market, including emergency physicians, hospitalists, and anesthesiologists, which private equity firms started rolling up in the early 2000s.
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Some have warned that the rapid growth of PE-backed practices is reminiscent of the rise and fall of physician practice management companies of the 1990s. In the second part of our series about the impact of private equity investment in physician practice on the healthcare market, we’ll hear from Peter Kindrachuk, a former PhyCor executive, on how today’s trend compares to what happened back then.
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Private equity firms are fueling a physician practice buying frenzy that’s heated up over the last year, with just about half of practices now owned by hospitals or other corporate entities.
In the first part of a series about private equity's impact on the market, Anthony D’Eredita, founder and CEO of TrustWorks Collective, discusses how younger physicians and health systems are being outbid by deep-pocketed investors.
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British digital-first value-based care company Babylon went from being virtually unknown in the US, to managing the cost of care for more than 100,000 lives in a year. Babylon's Chief Business Officer Paul-Henri Ferrand discusses how the company is partnering with health plans, medical groups, and health systems to expand.
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17 million healthcare workers need to be fully vaccinated by early January. Coverage expansion plans for 12 Medicaid holdout states could be a big boost to hospital bottom lines. And add CVS Health to the list of non-traditional physician employers.
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Tennessee lawmakers try to limit the power of the state’s medical board to discipline physicians. CMS boosts outpatient and home health payments, but some physicians will see a pay cut in 2022. And more COVID vaccine mandates go into effect.
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Democrats say they have reached a deal to address drug prices. A California judge sides with pharmaceutical companies in opioid litigation. And more women than men are using telehealth services.
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It’s November and that means open enrollment season for ACA plans. The Texas Medical Association challenges new surprise billing rules in court. And as vaccines become available for kids, when will we return to normal.
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Bids to add dental coverage to Medicare seem to be out of President Biden's new social spending framework. With the Medicare population is expected to grow by a third over the next decade as Baby Boomers turn 65, Oregon dentist Dr. Kaz Rafia says not adding dental coverage was a missed opportunity.
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Dental and vision benefits for seniors and prescription drug pricing reforms are out of President Biden’s social spending plan. Senators in Brazil want to charge the country’s president with crimes against humanity for how he has handled COVID-19. And the FTC is cracking down on smaller M&A deals.
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LifePoint Health and Kindred Healthcare are spinning off a new hospital company. Merck signs a licensing deal to let companies countries produce its antiviral covid pill. And health systems are starting new ventures to compete with electronic health record giants.
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Elementary school kids are one step closer to getting COVID vaccines. Utah hospitals call on people to donate unused crutches amid supply shortages. And two new players launch pharmacy benefit managers.
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Today an FDA panel is deciding whether to recommend Pfizer’s covid vaccine for young kids. Northeastern states pass new laws limiting nursing home profits. And several states reject bids to expand advanced practice providers' scope of practice.
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In the final episode of our series exploring investor acquisitions of physician practices, we’ll look at the hospital-based physician market, including emergency physicians, hospitalists, and anesthesiologists, which private equity firms started rolling up in the early 2000s.
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As Democrats pare down their social spending package some healthcare benefits are on the chopping block. Pediatric providers declare a national mental health emergency for kids. And Amazon Care is expanding to five more cities.
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Ahead of regulatory approval, the Biden Administration lays out plans to distribute COVID vaccine plans to young kids. The FDA kicked off the process of making hearing aids available over the counter. And more than 30,000 Kaiser Permanente employees authorized a strike.
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Where will healthcare workers who refuse to get vaccinated work after mandates are implemented? Despite warnings that ivermectin doesn’t help treat COVID, overseas generic drug makers are making big bucks off the medication. And UnitedHealthcare launches a virtual-first primary care plan.
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Instead of spotlighting the importance of the local public health officials, the pandemic has led to a public backlash against them. Large health systems are joining forces to lobby for hospital-at-home waivers to become permanent. And Walmart enters the employer-sponsored coverage market.
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Some have warned that the rapid growth of PE-backed practices is reminiscent of the rise and fall of physician practice management companies of the 1990s. In the second part of our series about the impact of private equity investment in physician practice on the healthcare market, we’ll hear from Peter Kindrachuk, a former PhyCor executive, on how today’s trend compares to what happened back then.
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Walgreens moves further into care delivery and launches a new health division. The FDA’s vaccine panel recommends Moderna booster shots. And the agency authorizes its first e-cigarette, but only the tobacco flavor.
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Medicare open enrollment starts Friday, but once signed up few seniors change plans. Companies are ignoring Texas’ vaccine mandate ban. And in California, Governor Newsom hasn’t delivered on his big healthcare reform promises.
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Best Buy makes another move into healthcare with plans to buy Current Health. The US Preventive Services Task Force is narrowing guidance on who should take aspirin to prevent heart disease. And nurses say patients are increasingly hostile and violent.
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Merck asks the Food and Drug Administration to approve its antiviral COVID pill. Get ready for the wave of physician retirements. And there’s a lot of activity among revenue cycle management companies.
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Private equity firms are fueling a physician practice buying frenzy that’s heated up over the last year, with just about half of practices now owned by hospitals or other corporate entities.
In the first part of a series about private equity's impact on the market, Anthony D’Eredita, founder and CEO of TrustWorks Collective, discusses how younger physicians and health systems are being outbid by deep-pocketed investors.
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Henrietta Lacks’ family sues biotech company Thermo Fisher Scientific for unfairly profiting from her cells. 2021 is the year of the mega-hospital merger. And Pfizer officially asks the FDA to extend emergency use for its COVID vaccine to include young kids.
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The WHO backs the first malaria vaccine. The Wall Street Journal writes about what is believed to be the country’s first cybercrime-related patient death. And increasing labor costs will continue to be a key concern for hospitals into next year.
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Missouri’s Medicaid expansion goes into effect. A group of health systems launches Graphite Health, a healthcare app marketplace. And long-serving NIH Director Dr. Francis Collins steps down.
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Merck’s new antiviral pill to treat COVID-19 shows a lot of promise. CMS lays out how the No Surprises Act dispute resolution process will work. And non-covid research is still lagging behind pre-pandemic levels.
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Sanford Health's Chief Physician Dr. Jeremy Cauwels discusses how the Sioux Falls, SD-based health system is building a virtual care center to consolidate its telemedicine offerings and deliver virtual care at scale.
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Healthcare worker shortages are problematic now, but a study project they’ll get worse in several states. This week Pfizer shared data with regulators on its COVID vaccine efficacy in young kids. Coast-to-coast healthcare worker vaccine mandates are working.
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Hospital-backed healthcare data company Truveta announces a deal with Microsoft. The American Medical Association's annual report finds a single insurer had at least half of the market in 46 percent of metro areas. And in response to a rise of attacks on healthcare workers, one Missouri hospital is adding panic buttons to employee badges.
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Look across the pond to France for more evidence that vaccine mandates work. Walmart Health adopts Epic’s electronic health record system. And regulators ask for more info about a merger between two Michigan hospital systems.
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New York state’s COVID vaccine mandate goes into effect. Devoted Health could be the most valuable insurtech with a valuation at more than $11B. And states start rolling out COVID vaccine booster shots.
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Capacity and staffing challenges from ongoing COVID surges are creating a domino effect, delaying access to other medical care and backing up emergency departments. Dr. Gregg Miller, Chief Medical Officer of hospital staffing company Vituity, says that these compounding factors are bringing sicker patients into overwhelmed and understaffed emergency departments.
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As vaccine mandates go into effect hospitals and nursing homes worry staffing shortages will get worse. There are renewed calls for more oversight over Medicare Advantage plans. And the FDA recommends seniors and adults with underlying medical conditions should get COVID booster shots.
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HCA Healthcare expands into fast-growing Utah. The official American death toll from the COVID pandemic has now surpassed that of the 1918 flu pandemic. And with seniors spending hundreds of dollars on dental and hearing care out-of-pocket, expanding Medicare to cover these benefits is hugely popular.
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Amid booster shot limbo, decisions are falling to doctors. With insurers rolling back COVID waivers patients are getting big bills. And Walgreens acquires a majority stake in specialty pharmacy company Shields Health.
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Intermountain Healthcare plans to merge with Colorado-based SCL Health. Pfizer says its vaccine elicited a strong immune response in 5-to-11-year olds. And health apps need to tell consumers if their data was exposed.
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Although the center of excellence model has been around for years, it has been mainly used by mega-employers. San Francisco-based Carrum Health is making this more accessible to smaller companies through its digital marketplace that connects self-insured employers with a network of providers.
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As booster debate intensifies in the US, the UK moves forward with its rollout. Hospitals are under pressure to add psychiatric beds. And Buzzfeed News traced the ivermectin as a covid treatment craze back to a questionable study out of Argentina.
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As COVID becomes endemic, we need to learn to live with the virus. The federal government accuses Aetna of operating ghost networks to secure Medicaid contracts. Medicare Advantage plans support adding dental, vision, and hearing benefits to traditional Medicare as long as they get higher payments.
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Hospitals continue to postpone non-emergent surgeries to preserve capacity for COVID patients. Stimulus dollars and government programs helped keep Americans out of poverty last year. And top vaccine regulators say there’s not enough evidence for booster shots.
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Hospitals react to Biden’s new vaccine requirement for healthcare workers. New transparency rules are released for air ambulance companies and insurers. And nursing homes prescribe antipsychotic medications to far more residents than reported.
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The Biden Administration plans to release another $25 billion in provider relief funding. Spreading false information about covid vaccines could cost physicians their license. And physician groups in Texas say the state’s new abortion law interferes with their ability to practice medicine.
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President Biden extends COVID vaccine mandates to cover 100 million Americans. And the Biden Administration's plan to reduce prescription drug prices backs top Democratic policy plans, including allowing Medicare to negotiate drug prices.
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As kids go back into the classroom, COVID cases rise. The FDA is set to decide which e-cigarette products can stay on the market. And as state vaccine requirements for healthcare workers go into effect, there are concerns it could wrosen staffing shortages.
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British digital-first value-based care company Babylon went from being virtually unknown in the US to managing the cost of care for more than 100,000 lives in a year. Babylon's Chief Business Officer Paul-Henri Ferrand discusses how the company is partnering with health plans, medical groups, and health systems to expand.
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A judge approves Purdue Pharma’s controversial bankruptcy settlement and some states vow to appeal. What is more effective at encouraging vaccination: full vaccine approval, mandates, or incentives? And adding dental to Medicare could take years.
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Two of the FDA’s top vaccine regulators are leaving as the COVID booster decision looms. Nurses are getting higher pay and more favorable contracts as hospitals are desperate for staff. And Apple is working on health tools that can track your fertility and blood pressure.
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In a troubling trend, a few judges have ruled hospitals need to treat COVID patients with ivermectin. Sutter Health settles an antitrust lawsuit and Medicare Advantage fraud suit. And telehealth giant Amwell completes its acquisition of two smaller digital health companies.
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A new study in The Lancet finds the Delta variant may actually cause more severe disease than previous strains. Jury selection starts in the trial of Theranos founder Elizabeth Holmes. And CVS and Walmart’s latest move into care delivery is offering mental healthcare in store.
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Oregon hospitals are struggling to handle the influx of COVID patients, partly because the state has the fewest hospital beds per capita in the nation. In this episode, we'll hear how National Guard troops are helping one Oregon hospital inundated with COVID patients and short on staff.
To take the 5 question survey go to Gisthealthcare.com/survey
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During this Delta surge, more pregnant women are ending up severely ill with COVID and physicians urge vaccinations. Religious groups and affiliated hospitals require the COVID-19 vaccine. And insurers expand marketplace offerings.
To take the 5 question survey go to Gisthealthcare.com/survey
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Doctors beg people to get their first vaccine doses, while companies ask for booster shot approval. Mental health apps Ginger and Headspace merge. And desperate for staff, places in Nebraska say no COVID vaccine necessary.
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The House advances the $3.5 trillion social spending package. Despite job losses from the pandemic, the uninsured rate stayed about the same. And the US Preventive Task Force is lowering the recommended age for Type 2 diabetes screening.
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After the FDA gave full approval for the Pfizer COVID-19 vaccine, a flood of new requirements followed. Google and Apple’s health initiatives struggle. And the latest groups to fight price transparency are businesses and pharmaceutical benefit managers.
To take the 5 question survey go to Gisthealthcare.com/survey
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More companies are mandating COVID vaccines every day, but not all mandates are created equal. Just as patients were returning to hospitals the Delta wave hit. And Anthem strikes a partnership with senior-focused primary care company CareMax.
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Health officials now say everyone needs COVID vaccine boosters. Clinical staffing shortages are leading hospitals to pay as much as 20 percent more than previous surges for travel nurses. And Verily Life Sciences gets deeper into clinical trials with a new acquisition.
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The Biden Administration is set to roll out a plan to give most Americans COVID vaccine booster shots. National Medicare Advantage spending continues to rise. And UnitedHealth launches its direct-to-consumer play.
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Immunocompromised Americans can now get COVID vaccine boosters. More insurers decline to cover the Alzheimer’s drug Aduhelm. And a new study challenges our long-held assumptions about metabolism.
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This latest Delta surge is putting public health officials and hospitals on their heels as beds fill up and hospitals struggle to find enough staff. Gist Healthcare co-founders Chas Roades and Lisa Bielamowicz discuss how hospitals are dealing with the fourth wave.
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Biden throws his support behind giving Medicare the power to negotiate drug prices. Costly health system cyberattacks are at an all-time high. And as the Delta variant surges across the US, consumers' confidence in traveling and other public activities is falling. According to a Jarrard Phillips Cate & Hancock survey, nearly a third of consumers said they are less likely to seek non-emergent in-person care.
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Some employers are considering charging unvaccinated employees higher premiums or the cost of testing. CVS Health launches its virtual first primary care offering to companies. And patients in Western North Carolina sue HCA Healthcare.
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As more companies mandate COVID vaccines, a law prevents hospitals from doing so in Montana. While ICUs fill up in Texas, the governor asks hospitals to postpone elective care. And with the infrastructure bill behind them, Democratic Senators move onto their $3.5 trillion budget resolution.
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As kids make up a larger share of covid cases, pediatricians implore the FDA to move quickly to approve the shots for young kids. Morgan Health makes its first investment. And rising COVID cases combined with patients returning for delayed care dampen health insurer profitability.
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Eric Passon, CEO of data strategy consulting firm Ancore Health discusses recent trends his firm has been watching in physician compensation. He outlines the need to update physician pay approaches to keep pace with the changing economics of health system medical groups.
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Vaccinated Americans are most concerned about the Delta variant while many unvaccinated think the shot is riskier than the disease. Enhanced federal subsidies caused individual insurance premiums to drop by 40 percent. And nursing homes start to mandate vaccines.
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The WHO says hold off on booster shots, but some Americans are already finding ways to get them. Medical boards start cracking down on physicians spreading vaccine misinformation. And the FTC says it can’t keep up with merger filings.
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A growing number of hospitals, companies, and even local governments announced more COVID vaccine requirements. Hospitals in the states with surging COVID cases are overwhelmed and can’t give adequate care. And CMS nixes a transparency requirement for hospitals and Medicare Advantage plans.
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The Missouri Supreme Court rules the state needs to provide coverage to the Medicaid expansion population. Leaders of some of the country's biggest health systems are calling on Congress to support gun violence prevention funding. And spas are popping up to treat long COVID patients.
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States reach a $26 billion settlement with three opioid distributors and Johnson and Johnson. As new daily COVID cases rise, the pace of vaccinations slows. And patients have been coming back for care they delayed because of the pandemic.
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CMS scales back plans to move more procedures to outpatient settings. As the Delta variant spreads and more breakthrough cases are reported, Nephron Research shares an outlook for the COVID testing market heading into the fall and winter. And a new study finds nearly a fifth of Americans have medical debt.
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Calls for vaccine mandates for healthcare workers intensify. Microsoft is integrating Teladoc’s virtual visit platform into its Teams software. And fines for hospitals not publishing prices could go up to $2 million per year.
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To explore the impact of a “Medicare at 60” policy on health systems, Gist Healthcare Analyst Patrick Grant discusses how he modeled the revenue implications for health systems if a large portion of their commercially insured patients aged 60 to 64 switched to Medicare coverage.
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Medicare plans to keep paying for telehealth services through next year. Two large health systems announce they won’t offer Biogen’s new Alzheimer’s drug. And in attempts to drive down prescription drug prices, states target the industry middlemen.
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Expanding Medicare benefits and Medicaid to holdout states are all part of Democrats' $3.5 trillion-dollar budget package. Tennessee’s top vaccine official was fired and outreach efforts halted amid rising COVID cases. And hospitals sue Intuitive Surgical alleging it’s abusing its monopoly power.
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Medicare starts the process of deciding how to cover Aduhelm. As insurers and employers sign on, teletherapy gains momentum. And two states with similar COVID case rates took different paths - one resulted in a lot more deaths.
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Pfizer meets with top health officials about a booster shot. Missouri’s Medicaid expansion case goes before the state’s highest court. And President Biden supports price transparency but still many hospitals aren’t complying.
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President Biden signed a sweeping executive order aimed at increasing competition. Funding for digital health companies continues to break records. And the FDA chief calls for an investigation of the agency's approval of Alzheimer's drug Aduhelm.
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Pfizer plans to seek approval for a COVID booster shot. 15 states have come to a settlement agreement with Purdue Pharma. And Biogen updates prescribing recommendations for its new Alzheimer’s drug Aduhelm.
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Dollar General makes a play at healthcare. A health system executive is tapped to lead Medicare. And researchers used birthday parties as a proxy for the role small gatherings played in spreading COVID.
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The Delta variant fuels COVID surges in poorly vaccinated parts of the US. New rules prohibit most surprise medical bills when patients get care from out-of-network providers. And healthcare, much like other industries, is struggling to find workers.
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Missouri finds itself in the grip of another COVID surge as the state struggles with low vaccination uptake. Dr. Davin Turner, Chief Medical Officer of St. Joseph, MO-based Mosaic Life Care says if vaccinations don’t increase, he expects ongoing surges to become the new normal.
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Oklahoma becomes the 37th state to implement Medicaid expansion. There’s more consolidation in the home health space. And an independent analysis finds Biogen’s Alzheimer's drug would be cost-effective if priced seven times less than the company’s list price.
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Walmart will start selling its own brand of analog insulin. With the Supreme Court declining to hear the case, Medicare’s site-neutral payment rule in place. And e-cigarette maker Juul agrees to pay North Carolina 40 million dollars to settle a lawsuit.
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The Biden Administration is taking steps to bolster the ACA marketplaces. Nearly 7 in 10 physicians are employed by insurers, private equity firms, or other companies. And hospitals are dealing with more cyberattacks.
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After being berated, harassed, and bullied throughout the pandemic - public health experts report feeling anxious and depressed. Vaccines are the key to beating the Delta variant, yet convincing holdouts is challenging. The Centers for Medicare and Medicaid Services has tapped Daniel Tsai to lead the agency’s Medicaid division.
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Dean Sanpei, Chief Strategy Officer at Centennial, Colorado-based Centura Health discusses the new 'Colorado Option' and lessons learned from other states.
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A judge rules Missouri’s ballot measure to expand Medicaid is unconstitutional. Eli Lilly plans to test the FDA’s new standard and apply for approval of its Alzheimer’s drug. And the latest health tech insurer startup, Bright Health, goes public.
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COVID cases are surging in parts of the Midwest where few are vaccinated. DuPage Medical Group expands into Indiana. And a Wall Street Journal article details the entangled relationship between Steward Health Care and its landlord.
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Despite big-ticket incentives vaccinations are still slow in young adults. Medicaid enrollment hit record highs during 2020. And could the plethora of remote monitoring lead us to a world where doctors are always watching us but never at the bedside?
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Nashville-based health system LifePoint Health announced plans to acquire Louisville-based Kindred Healthcare. The VA says it will now cover gender-affirming surgeries. And Democratic Senators are considering expanding Medicare benefits.
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In May, the Lown Institute published a ranking of which hospitals deliver the greatest amount of “low value” care. In this episode president of the nonpartisan think tank, Dr. Vikas Saini discusses the methodology used in constructing that measure.
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The Affordable Care Act has survived its latest legal Supreme Court challenge. Michigan’s Beaumont Health is hoping a third merger attempt is a charm. And vaccinated immunocompromised patients may get more benefit from a third dose.
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Anthem joins CivicaRx’s division to bring lower-cost generic drugs to pharmacies. The first patient receives the controversial newly approved Alzheimer's medicine. And some research finds vaccine mixing holds promise.
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Some states lift nearly all pandemic restrictions as vaccination rates reach the 70 percent threshold. Humana deepens its push into home care with another acquisition. And a charity buys up nearly $300M in medical debt.
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A judge tosses out the case challenging Houston Methodist’s vaccine mandate. HCA Healthcare trauma centers are charging patients up to 10 times more than other trauma centers. And more than 1M individuals bought coverage on Healthcare.gov since February.
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Dr. Farzad Mostashari, CEO and co-founder of Aledade, discusses how quality reporting for physicians has become time-intensive and no longer commensurate with incentives. He tells us the whole system is in need of “radical surgery”.
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After blowback, UnitedHealthcare delays its policy of not covering emergency department visits it deems unnecessary. Datavant and Ciox Health announce plans to merge. And Biogen’s newly approved Alzheimers has a huge price tag.
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The heart rate, sleep and exercise data Apple devices capture can now be sent to your electronic health record. Hospitals start enforcing vaccine mandates and penalties for non compliance. And the pandemic has changed how we use the emergency department.
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Retail giants Amazon and Walmart go head to head with competing pharmacy offerings. UnitedHealthcare will start denying emergency department claims if it deems a past visit to the ER nonemergent. One for-profit and one nonprofit medical school look to expand in Montana.
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One Medical is acquiring senior-focused primary care company Iora Health. The FDA approves the first Alzheimers drug in 18 years. And Colorado Children's Hospital is so overwhelmed with pediatric mental health patients, last month it declared a state of emergency.
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Now that vaccinated Americans are out and about, get ready for those seasonal viruses to make a comeback. Physician Assistants vote to change their title. And Dr. B promised to match leftover vaccine doses to recipients, but it's unclear the service actually helped any patients get shots.
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Companies are offering free baseball tickets, beer, flights with vaccines. Democrats are trying to find a federal work-around to expand Medicaid in holdout states. And a UK telemedicine company is buying up large numbers of doctors in the US.
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As the debate around employers requiring workers to get the COVID-19 vaccination continues, another system announced a mandate. Greensboro, NC-based Cone Health and Norfolk, VA-based Sentara Healthcare call off merger plans. And Nevada legislators send a public option bill to the governor.
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Dr. Bryan Kibbe, a clinical ethicist at Marietta, GA-based Wellstar Health System discusses factors systems are considering as they decide whether to make the COVID vaccine mandatory for employees.
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Houston Methodist CEO Dr. Marc Boom discusses how the health system decided to become the first in the nation to require its workforce to receive the COVID vaccine. Boom says the requirement was intended to get to the “last mile” of full vaccination, and now more than 98 percent of the system’s staff are immunized.
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Lowering the Medicare eligibility age to 60 is getting a surprising amount of support from centrist Democrats. Many employers are encouraging employees to get vaccinated but stopping short of mandates. And Colorado is offering to pay hospitals to close free-standing emergency rooms.
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JPMorgan launches its own health business unit. Chiquita Brooks-LaSure is confirmed as the head of CMS. And Google partners with Nashville-based HCA Healthcare to develop algorithms using millions of patient records.
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The pandemic is causing women to leave the workforce at higher rates than men, leading some to call this economic downturn the 'shecession'. Dr. Neelum Aggarwal, a cognitive neurologist at Rush University Medical Center and the Chief Diversity and Inclusion Officer at the American Medical Women's Association discusses how this pullback is impacting female physicians.
This episode was originally published in January 2021.
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Two former competitors, a rural North Dakota critical access hospital and community health center, joined forces to rationalize care and better serve their community. We explore this unique collaboration and whether it can be replicated in other underserved communities.
This episode was originally published in March 2021.
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Co-founder and CEO of DispatchHealth Dr. Mark Prather discusses how the Denver-based company is expanding from its roots in on-demand urgent care home visits to provide home-based services across the full continuum of care, including hospital-level care through a new partnership with Humana.
This episode was originally published in February 2021.
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Bremerton, Washington-based Peninsula Community Health Services is working with church and other community leaders to connect with individuals who are hesitant to get the shot.
This episode was originally published in March 2021.
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Nevada lawmakers are debating a public option-style health plan. Google unveils another AI tool, this time for skin conditions. And now that patients have more access to their medical records as part of new federal rules, doctors are navigating how to handle it.
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Over a standard course of treatment, cancer patients often spend hundreds of dollars, if not more than a thousand, on parking. Amid structural changes within the Centers for Disease Control and Prevention, two top female scientists are leaving the agency. Advocates push for COVID survivor registries modeled after registries created after 9/11.
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States and retailers are navigating the new mask guidance, leading to a patchwork of rules. The Department of Health and Human Services is asking the Supreme Court to keep the site-neutral payment policy in place. And two hospital giants make a big investment in hospital-at-home care.
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Gist healthcare co-founders Chas Roades and Dr. Lisa Bielamowicz talk about recent investment activity in primary care startups, which are trying to revamp the traditional practice model by putting consumers at the center.
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The CDC now says fully vaccinated people don't need masks in most places. Missouri Governor withdraws plans to expand Medicaid. The COVID crisis inspired a ton of research but exposed flaws in the evidence pipeline.
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Five lucky vaccinated Ohio adults stand to win a million dollars. A cyberattack is still crippling San Diego-based Scripps Health more than a week later. And as we approach the end of the public health emergency physicians, insurers and telehealth companies are pushing lawmakers to take permanent steps to expand telehealth flexibilities.
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Close to one million people have bought health insurance during the special enrollment period. Hospitals and physicians are awaiting the last disbursement of relief dollars. And drugmakers are testing a medication for obesity.
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The FDA expands the emergency use of the Pfizer and BioNTech vaccine for adolescents. Walmart buys telehealth company MeMD. And Cigna sees preventive care return to pre-pandemic levels.
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Concert Health CEO Spencer Hutchins discusses how the San Diego-based behavioral health medical group works in tandem with primary care providers to treat patients with behavioral health needs.
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The US is supporting the effort to waive patent protections for COVID vaccines. Almost all hospitals are still doing unnecessary procedures according to a Lown Institute study. And the story of a mental health hack in Finland should serve as a warning as the popularity of virtual mental apps grows.
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The next step in the vaccine rollout is the hardest, convincing vaccine-hesitant people to get shots. Hospitals inTexas are concerned about the Medicaid funding showdown. And The National Academies of Sciences, Engineering, and Medicine joins calls to reinvest in primary care.
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President Biden wants 70 percent of American adults to get at least one vaccine dose by July 4. CVS Health is continuing to expand its care delivery business. And regulators are starting to fleshing out the details of the surprise billing protections.
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There’s doubt that the US will reach herd immunity, because of vaccine hesitancy and more contagious variants. Insurers were more profitable in 2020 despite paying for COVID-19 testing and treatment. And companies are overwhelmed by all the digital health options
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Virginia-based Privia Health, one of a growing number of high-profile “physician enablement” firms that helps practices improve operations and transition to value-based care delivery, held its initial public offering this week. CEO Shawn Morris discusses how the company plans to grow.
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New York is planning to fully reopen on July 1. The FDA announced a ban on menthol cigarettes and flavored cigars. And employers say it’s time the government helps control healthcare costs.
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President Biden's American Families Plan doesn’t include drug pricing legislation, a priority of many Congressional Democrats. CMS is proposing an inpatient rate bump for hospitals next year. And the American Medical Association calls for states to stop banning gender-affirming care for transgender kids.
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Colorado lawmakers are bringing back a public option proposal. In West Virginia, young adults can get a COVID vaccine and a savings bond. And a new study in mice provides evidence that an old drug might help people heal from surgeries without a scar.
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The US is sharing millions of AstraZeneca vaccine doses with other countries. Private equity firms are rolling up veterinary practices in the United Kingdom. And Accolade announces plans to acquire telehealth company PlushCare.
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Sean Lane, CEO of healthcare software company Olive, discusses how the company uses artificial intelligence to automate repetitive processes for hospital systems. The technology has been deployed in more than 600 hospitals across the country.
This episode is a rerun and was initially published in November.
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A CDC committee will decide whether to resume the Johnson & Johnson vaccine rollout. A KFF and Washington Post poll finds 3 in 10 healthcare workers are considering leaving the profession because of the pandemic. And Democrats plan to add more healthcare provisions to the upcoming infrastructure bill.
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The country has administered 200 million shots but in some places, demand is falling. Insurer Oscar Health launched its tech platform, called +Oscar, for payers and providers. And UVA Health says it will drop a long backlog of lawsuits against patients.
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Some businesses are requiring proof of covid vaccinations, but government issued paper cards are easy to fake. A small number of drugs account for a large part of Medicare’s spending. And the Biden Administration is considering lowering the nicotine level in cigarettes.
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All adults are eligible for COVID vaccinations. The federal government rescinds the Medicaid waiver for Texas that covers uncompensated care. And insurers are launching virtual first primary care plans with low premiums.
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Medically Home CEO Rami Karjian and oncology division president Patty Brown discuss how the hospital-at-home trailblazer is now treating cancer patients at home. As the popularity of “care anywhere” grows in the wake of the pandemic, disruptors are expanding the breadth of conditions that can be treated at home.
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The CDC is studying some reports of breakthrough covid infections among fully vaccinated Americans. UnitedHealth Group’s growth is being led by its rapidly expanding Optum division. And beyond COVID relief bills Democrats haven’t yet fully revealed their health agenda.
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A CDC panel decides to continue the pause on the Johnson and Johnson vaccine while it gathers more information about the rare cases of blood clots. President Biden signs a bill delaying the Medicare sequester cuts. And a health system is locked in a legal battle with a travel nurse staffing firm.
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Federal health agencies are calling states to pause the Johnson and Johnson vaccine rollout. Another startup health insurer Bright Health snaps up a telehealth company. And for the second year in a row insurers are on track to return a lot of money to beneficiaries.
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The CDC declares racism is a serious public health threat. Pfizer asks the FDA to clear its COVID vaccine for kids 12 and older. And Microsoft is acquiring speech recognition company Nuance Communications.
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In the first part of our conversation with healthcare futurists Jeff Goldsmith and Ian Morrison, they said it’s time to reconsider the social impact of hospital systems because of the vital role they played during the pandemic. In this episode, Ian and Jeff discuss how large health systems should be leveraged as the country rebuilds its public health infrastructure.
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A quarter of American adults are fully vaccinated, but public health experts are concerned an increase in cases could lead to another surge. Missouri lawmakers are refusing to fund the state's Medicaid expansion. And a bunch of companies in the physician practice space are planning to go public.
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More than half a million people signed up for health insurance during the special enrollment period. The American College of Physicians is recommending providers prescribe shorter courses of antibiotics. And 60 percent of frontline workers say their mental health suffered during the pandemic according to a new Kaiser Family Foundation and Washington Post poll.
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President Biden moves up the deadline for states to open vaccinations to all adults to April 19. Investors poured a record-breaking $6.7 billion into the digital health sector last quarter. And while nursing homes struggle to keep patients and health systems invest in-home care.
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Hospitals and nursing homes debate whether to require COVID vaccinations for employees. An anesthesia group is taking UnitedHealthcare to court. And more than 40 Oregon insurers and providers pledge to move away from fee-for-service payment.
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Healthcare futurists Jeff Goldsmith and Ian Morrison say it’s time to reconsider hospital systems' social impact. In a recent Health Affairs editorial, the two write health system scale has been essential to procuring personal protective gear, expanding bed capacity, and quickly standing up telemedicine solutions.
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Pfizer says its covid vaccine is 100 percent effective in kids over 12. The federal incentives weren’t enough for Wyoming to expand Medicaid. And some shake-ups at Walmart Health lead to questions about its healthcare strategy.
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The FTC challenges its first vertical healthcare merger in years. President Biden’s American Jobs Plan includes large investments in home health. And some small businesses hard hit by the pandemic are struggling to afford health coverage.
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Health officials warn of a fourth COVID surge. Tensions between therapists and a virtual mental health app play out in Reno, NV. And more expensive outpatient care is driving spending growth in Massachusetts.
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Dr. Deborah Birx tells CNN a more aggressive COVID response could have saved hundreds of thousands of lives. Regulators are looking into UnitedHealth Group’s acquisition of Change Healthcare. And the JAMA’s editor-in-chief is on leave after a controversial podcast episode about racism in medicine.
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Kristen McGovern, a partner at healthcare consulting firm Sirona Strategies, discusses the next evolution of value-based payment: Medicare’s Direct Contracting model. The first group of participating organizations starts the demonstration this week.
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Price transparency in New Hampshire didn’t lead consumers to get cheaper care, according to a Health Affairs study. Uber is expanding its pharmacy delivery business. And hospitals are struggling to balance patient care, staffing shortages, and higher expenses amid the pandemic.
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The pandemic is accelerating medical schools' shift to virtual dissections. Epidemiologists say scaling up testing is the key to controlling the pandemic in the long term. And lawmakers agree on a plan to delay Medicare payment cuts.
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Federal officials say AstraZeneca released outdated information about its COVID vaccine trial. The Biden Administration is extending the special enrollment period through August. And some covid patients are doing smell therapy to recover the sense.
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With so many seniors vaccinated the CDC reports, the percentage of Americans 65 and older going to hospitals for COVID-19 is lower than 26 to 45-year-old adults. The American Hospital Association is pushing for antitrust scrutiny of UnitedHealth Group's acquisition of Change Healthcare. And in Maryland, there’s legislation to prevent hospitals from taking some patients to court over unpaid bills.
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Gist Healthcare co-founders Lisa Bielamowicz and Chas Roades discuss how strategies around scale in healthcare have evolved over the course of the pandemic—and how payers and disruptors are doubling down on virtual and home-based care as they shift toward vertical integration.
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As more contagious coronavirus variants spread, cases inch up in some states. The FDA is trying to figure out how to regulate software as a medical device. And according to a new study in Health Affairs, the majority of hospitals are not being transparent about their prices.
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Amazon is expanding its virtual care service to employees and other employers around the country. The Biden Administration is expanding COVID testing. And as consumer confidence returns will people go back to the doctor.
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The vast majority of people are getting both doses of the two-shot COVID-19 vaccines on time. Grand Rounds and Doctor on Demand announce plans to merge. And continuous glucose monitor companies are trying to reach the millions of diabetics, even though evidence about efficacy for some patients is still limited.
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A New York Times investigation finds the CMS nursing home star rating system is broken. As telehealth providers cross state lines competition heats up. And Biden Administration is set to roll out a public relations campaign to encourage skeptics to get vaccines.
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Two former competitors, a rural North Dakota critical access hospital and community health center, joined forces to rationalize care and better serve their community. We explore this unique collaboration and whether it can be replicated in other underserved communities.
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President Biden is directing states to make all adults will be eligible for the vaccine by May 1. The Supreme Court is no longer hearing a case challenging the legality of Medicaid work requirement case at the end of the month. And people are sharing their COVID vaccine status on dating apps.
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The $1.9 trillion COVID relief bill heads to the President’s desk. A California judge approves the landmark antitrust settlement against Sacramento-based Sutter Health. And new recommendations suggest smokers get screened for lung cancer earlier.
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Vaccine demand varies dramatically across the country. The new COVID relief bill includes a big boost in tax credits for individuals buying health insurance on the marketplace. And an article in the New Yorker investigates why COVID-19 has hit some more developed countries harder than lower-income countries.
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The CDC says fully vaccinated people can gather together inside without masks. The federal government is offering big incentives to expand Medicaid. But will it convince the 12 holdout states? And new reporting finds New York Governor Andrew Cuomo’s advisers altered reports to hide nursing home deaths.
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Traditional health systems are facing an increasingly competitive market, as retailers, payers, and telehealth providers are getting deeper into the care delivery business. Newport News, VA-based Riverside Health System is using patient outreach and care navigation platform Upfront Healthcare to build consumer loyalty and drive patients back to the health system for missed care.
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Regulators are investigating OneMedical for letting people jump the vaccine line. The Senate COVID relief bill includes more money for rural hospitals. And nonwhite caregivers say they face more discrimination when trying to get care for a loved one with Alzheimer's disease.
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Now that you’re fully vaccinated, what social gatherings are safe? The Centers for Disease Control and Prevention is set to release new guidance. Amazon Care looks like it’s laying the groundwork for a large expansion. And lawmakers say it’s time to make telehealth flexibilities for seniors permanent.
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President Biden says by May there will be enough vaccines for all adults. When private equity firms buy nursing homes deaths increase, according to new research. Arkansas, the first state to implement Medicaid work requirements, now has a new plan.
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Mass vaccination sites are popping up in several states and primary care doctors are getting few doses. Cigna is acquiring telemedicine company MDLive. And the FTC drops its challenge to a hospital merger in Philadelphia.
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Bremerton, Washington-based Peninsula Community Health Services is working with church and other community leaders to connect with individuals who are hesitant to get the shot.
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Hospital giant HCA Healthcare is expanding into post-acute care and home health. COVID-19 cases and hospitalizations are going down but how will we know when the pandemic is over. And a new Kaufman Hall report projects hospitals could lose up to $122 billion this year.
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The FDA says Johnson and Johnson single-dose vaccine is safe and effective. Insurers are making big investments in-home healthcare. And young adults are reporting feeling very lonely as they socially isolate during the pandemic.
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Pharmaceutical executives tell Congress vaccine supply will increase in March. Confirmation hearings are underway for Xavier Becerra, the nominee to lead HHS. And some telehealth companies aren’t just focused on direct patient care, but also partnering with health systems.
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500,000 Americans have died from COVID-19. IBM is reportedly considering selling its Watson Health business. And as Match Day approaches, there are still thousands of medical school graduates who struggle to find a program.
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Dr. Bela Patel, the division director of critical care medicine at McGovern Medical School at UTHealth in Houston, discusses lessons learned from the pandemic. Providers quickly adapted to emerging science because of local and international collaborations and Patel wants to carry that forward as hospitals move past this crisis and prepare for future ones.
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Two Democratic senators are reviving their public option bill. Google is opening an office 10 minutes away from Mayo Clinic. And during the pandemic, medical research has moved into patient's homes.
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President Biden has reportedly picked Chiquita Brooks-LaSure to lead CMS. The CDC is working to pick up the pace of sequencing COVID-19 tests to track variants. And about a third of people delayed or skipped care during the pandemic - will they come back?
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Daily COVID-19 cases are down from record highs, but experts it's important to continue public health measures as more contagious variants spread. CVS Health’s insurance arm Aetna will start selling insurance on the marketplace next year. And the Biden Administration started unwinding Medicaid work requirements.
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The pandemic has hit struggling rural hospitals hard. Michael Topchik, national leader for rural health at healthcare consulting firm The Chartis Group discusses how although more hospitals are vulnerable, he's optimistic the Biden Administration’s focus on health equity could lead to new payment models that allow rural hospitals to focus more on emergency and outpatient care.
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14 of the country’s largest health systems are joining together to create a company to capitalize on their valuable troves of health data. Starting Monday, millions of Americans will have another chance to buy health insurance plans on the individual marketplace. And an Ohio-based emergency medicine practice is buying out its minority partner, a private equity firm.
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In a rare showing of unity, associations representing hospitals, physicians, insurers as well as business groups are backing President Biden’s plans to expand health coverage. The CDC is emphasizing how important mask fit is for protection. And pharmacies are hiring thousands to help administer vaccines.
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Democrats propose bigger tax credits to make individual health coverage more affordable as part of the COVID relief package. Since COVID-19 vaccines have been so effective, some scientists are pushing for a pancoronavirus vaccine. And providers raise concerns about virtual care post-pandemic.
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South Africa halts the distribution of the AstraZeneca COVID vaccine because of concerns it doesn't offer good protection against a variant, first identified in the country. Health insurance startup Oscar Health files to go public. And there have been almost no flu cases this year.
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Co-founder and CEO of DispatchHealth Dr. Mark Prather discusses how the Denver-based company is expanding from its roots in on-demand urgent care home visits to provide home-based services across the full continuum of care, including hospital-level care through a new partnership with Humana.
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Johnson and Johnson is seeking emergency approval for its single-dose covid vaccine. There’s new reporting about who’s the top choice to run CMS. And Kansas wants to use revenue from medical marijuana to expand Medicaid.
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Some insurers are paying pediatricians so little for rapid covid tests, some stopped offering them. British health officials are going door-to-door testing thousands to stamp out a coronavirus variant. And Manaus, Brazil is struggling with a COVID surge and a shortage of oxygen.
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Senate Democrats take the first step to move President Biden’s coronavirus relief bill forward. Independent scientists confirm Russia’s Sputnik V vaccine is more than 90 percent effective. And despite treating fewer patients, HCA Healthcare reports big profits in 2020.
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Hospital programs to treat COVID long haulers grow as scientists try to figure out what’s causing prolonged illness. States are dumping a vaccine software the government spent millions on. And Uber is expanding its prescription delivery service.
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We are airing an episode from the health policy podcast Tradeoffs titled “We Need You”.
Nursing home workers and residents have been prioritized for COVID-19 vaccinations because of how deadly the pandemic for both staff and residents. But in the first several weeks of the rollout, many workers have passed on getting the injection. The Tradeoffs team dug into vaccine hesitancy among nursing home staff—and found deep, longstanding challenges that extend well beyond the decision to take the COVID-19 shot.
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President Biden takes more action to roll back Trump’s healthcare moves. People trying to get COVID-19 vaccines in many states struggle to get an appointment. And more non-smokers are getting lung cancer, we highlight a report from one of the disease victims.
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Walgreens Boots Alliance has chosen Starbucks Chief Operating Officer Rosalind Brewer to take over as CEO. President Joe Biden is expected to take more healthcare executive actions to expand insurance coverage. And Anthem reports continued Medicare Advantage growth.
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President Biden is giving states more vaccines and more time to plan. Israel is leading the world in COVID-19 vaccinations. And healthcare workers report the pandemic is taking a toll on their mental health.
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Google, Amazon, and other large companies are offering help with COVID-19 vaccine distribution. As more transmissible coronavirus variants are identified in the US, vaccine makers are working to catch up. And President Biden says he’s willing to negotiate on the $1.9 trillion relief proposal.
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Price transparency and interoperability rules are continuing to make healthcare more consumer-driven. Kristen Valdes, founder and CEO of healthcare technology company b.well Connected Health and Board Member of the CARIN Alliance, believes the industry is shifting toward consumerism and early adopters of transparency will gain patient loyalty.
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Exactly a year ago this week, the first case of the novel coronavirus was confirmed in the US. Since then there have been more than 24 million cases and more than 400,000 deaths. One year later, President Biden laid out a new detailed, fortified response guided by science.
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During President Biden’s first few hours in office, he took several COVID-19 actions, including a mask mandate on federal property and rejoining the World Health Organization. UnitedHealth Group is continuing to grow its care delivery business. And coronavirus vaccine trials in kids have started but are struggling to recruit participants.
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The country has reached another terrible milestone - 400 thousand lives lost to COVID-19. Lawmakers say the last minute attempt to extend Medicaid waivers is invalid. And President-elect Biden fills out his healthcare team and is expected to take immediate action on COVID.
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Amidst all the health news in 2020, a new defined contribution model started. The Individual Health Coverage Reimbursement Arrangement or ICHRA - is projected to shake up employer insurance and double the size of the individual market. Jack Hooper, CEO of Take Command Health discusses how small and large employers are expressing interest.
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President-elect Biden unveils his coronavirus relief proposal which includes injecting billions into the coronavirus vaccination effort. Democrats want to revive legislation to let Medicare negotiate drug prices. And payers and startups are seizing on the popularity of telehealth.
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Healthcare companies are joining the wave of corporations pausing political donations. Scientists say the coronavirus is likely here to stay. And billionaire Mark Cuban enters the generic drug market.
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The federal government announces sweeping changes to speed up vaccinations amid the deadly covid surge. West Virginia is one of the few states with the smoothest vaccine rollout to date. And the pace of provider mergers and acquisitions is likely to pick up in 2021 after health systems and physician groups took big financial last year.
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Some within the transition are concerned about meeting Biden's 100 million vaccines in Biden’s first 100 days goal. CMS approves the first block grant for Tennesee's Medicaid program. And the doctor leading the health equity task force says we need to address not only access to testing and vaccines, but also social and financial challenges.
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In the first conversation of the year Gist Healthcare co-founders Chas Roades and Lisa Bielamowicz discuss the healthcare trends they're watching in 2021, including the coronavirus vaccine rollout, the healthcare policy agenda, and whether patient volumes will return to pre-pandemic levels.
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Dr. Fauci says the already bad COVID situation is going to get worse this month. A contract dispute leaves thousands of doctors out of network and surprise billing protections don’t start till next year. And healthcare jobs are returning slower for women than men.
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Hospitals now have to publish previously secret prices negotiated with insurers. A study finds COVID cases and deaths are much higher than reported. Emergency departments have seen big drops in patients since the start of the pandemic, some of which may be due to positive lifestyle changes.
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The COVID vaccine rollout is slow, plagued with confusion, and way behind schedule. After three years the Amazon, Berkshire Hathaway and JP Morgan Chase joint venture, Haven, shutters. And control of the Senate and Biden’s healthcare agenda rests with Georgia’s runoff races.
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The pandemic is causing women to leave the workforce at higher rates than men, leading some to call this economic downturn the 'shecession'. Dr. Neelum Aggarwal, a cognitive neurologist at Rush University Medical Center and the Chief Diversity and Inclusion Officer at the American Medical Women's Association discusses how this pullback is impacting female physicians.
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Walmart Health Centers are springing up outside of Atlanta, GA, and providing "everyday low prices" for comprehensive primary care. In Georgia, some local providers are surprisingly welcoming of the new offering.
This episode is a rerun and was initially published in October.
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Founder and CEO of Remedy Dr. Jeremy Gabrysch said the immediate care and telemedicine startup was well-positioned to deliver care in the wake of COVID-19, providing care digitally or in patients’ homes.
This episode is a rerun and was initially published in May.
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Travis Messina, CEO of hospital-at-home company Contessa, talks about the growing popularity of the model, the challenges of building a program, and the culture shift it requires. He compares the hospital-at-home model’s potential to that of early ambulatory surgery centers, which performed only a handful of procedures until Medicare expanded coverage and reimbursement.
This episode is a rerun and was initially published in August.
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Medically Home co-founder and CEO Raphael Rakowski and Chief Medical Officer Dr. Pippa Shulman discuss hospital-at-home care, which has become increasingly popular during the coronavirus pandemic.
This episode is a rerun and was initially published in June.
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Dr. Rushika Fernandopulle, co-founder and CEO of the value-based primary care organization Iora Health discusses how COVID led practices to reorganize around the patient, instead of the physical office.
This episode is a rerun and was initially published in September.
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Hands-on clinical experience is a key part of training for nurses. But the pandemic has led many facilities to halt in-person clinical rotations to preserve medical supplies and ensure student and patient safety. Howard University nursing students say the lack of in-person training is leaving them feeling unprepared to enter the workforce.
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Dr. Jeffrey Stalnaker, Chief Clinical Officer of Rockledge, FL-based Health First, discusses monoclonal antibody treatments for COVID patients, and why uptake has been disappointingly low. Stalnaker also shares his thoughts on vaccine rollout and adoption by health system employees.
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An FDA panel recommends the agency approve Moderna’s COVID-19 vaccine for emergency use. And despite pandemic uncertainty, private equity and venture capital deals in healthcare were strong in the third quarter. Dr. Charles Kennedy, CEO of private equity firm Blue Ox Healthcare Partners, expects strong investment in the digital health space to continue into next year.
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Newly released emails from a scientific advisor to the Department of Health and Human Services, show he was pushing a herd immunity strategy for the coronavirus. Pfizer is negotiating a deal with the US government to provide more vaccine doses. And gene-editing technology known as CRISPR is showing promise as a potential cure for sickle-cell anemia.
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The Food and Drug Administration says Moderna’s vaccine candidate is 94 percent effective. Lawmakers revive a surprise billing fix as part of the year-end spending bill. And newly authorized at-home COVID testing kits could make testing much more convenient.
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The first COVID-19 vaccine doses are being given across the US. Today’s the last day for people to buy a plan on healthcare.gov. And a Wall Street Journal editorial about Jill Biden’s doctorate drew swift criticism as a sexist attack on her credentials.
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As COVID patients flood hospitals in several parts of the country, hospitals turn to healthcare staffing firms to find critical care nurses.
Buffy White, Group President of healthcare staffing firm Cross Country Healthcare discusses how volatile demand for healthcare workers, especially nurses has only exacerbated shortages.
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An FDA advisory panel recommends the agency give emergency authorization to the Pfizer and BioNTech COVID vaccine. After a Series C funding round, Cityblock Health is now valued at more than $1 billion. And the Supreme Court upholds an Arkansas law regulating pharmacy middlemen.
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As the country reaches a record of more than 106,000 COVID hospitalizations, some hospital leaders say they're close to reaching crisis standards of care. And one pharmaceutical company is working to bring back a drug for hemophilia patients.
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The first covid shots are given in the United Kingdom. Pfizer and BioNTech's vaccine offers some immunity after the first dose. And Sweden ends its COVID experiment and imposes restrictions.
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The first COVID-19 vaccinations are starting in the United Kingdom. President-elect Biden picked California Attorney General Xavier Becerra and infectious disease specialist Dr. Rochelle Walensky to lead two of the nation's top health agencies. Sanford Health halts merger discussions with Intermountain Healthcare.
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Dr. Christopher Crow, CEO of Plano, TX-based Catalyst Health Network, an independent clinically integrated network, discusses how the pandemic-induced recession is accelerating employer and insurer interest in changing the way they pay for care.
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To boost COVID vaccine participation three former presidents say they’ll get the immunization on camera. States and hospitals are pulling nursing students forward to help with COVID-19 care. And President-elect Biden asks Dr. Anthony Fauci to join his administration.
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The United Kingdom approves Pfizer and BioNTech's COVID-19 vaccine. 2020 Healthcare spending dropped by about 2 percent from last year. And Medicare is out with final rules that expand telehealth, adjust physician pay, and allow more procedures to be done in outpatient settings.
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A CDC vaccine panel recommends healthcare workers and residents in long term care facilities get the first COVID-19 vaccines. States are taking a more nuanced approach to halting elective care amid the COVID surge. And despite COVID headwinds UnitedHealth Goup still expects growth next year.
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Moderna becomes the second company to ask the FDA for emergency approval of a COVID-19 vaccine. And the Centers for Medicare and Medicaid Services expands its 'Hospital Without Walls' program to pay for hospital-level care in the home. As Travis Messina, CEO of hospital-at-home company Contessa, says staff will still be the limiting factor for how much hospitals can increase bed capacity.
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Privia Health's Senior Vice President of Business Development, Mike Flammini, discusses how the company is now working with health systems to create a new model for physician alignment. And Drew Rector, Chief Strategy Officer of Rockledge, Florida-based Health First, one of the health systems Privia is working with, discusses how the partnership is helping the system grow its physician network.
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The CDC is recommending American's stay home for Thanksgiving to prevent the spread of COVID-19. President-elect Biden says delaying the transition during a pandemic is going to cost lives. And the WHO recommends against using an FDA approved COVID treatment.
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Pfizer reports its vaccine is 95 percent effective and plans to apply for emergency FDA approval within days. With high rates of infection across several states, more than a fifth of hospitals are reporting staffing shortages. And in today's COVID Audio Postcard, a contact tracer tells us she’s finding more cases of entire families being infected.
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In a highly-anticipated move, Amazon launches it’s pharmacy business. The American Medical Association recognizes racism as a public health threat. And Oregon’s governor calls on Congress to compromise on a coronavirus relief package now.
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One South Dakota nurse says some dying coronavirus patients are in such denial, that they are still refuting that COVID-19 exists. Some private practices and doctors so stressed by the pandemic are closing or retiring early. And Moderna reports it's vaccine candidate is more than 94 percent effective.
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Sean Lane, CEO of healthcare software company Olive, discusses how the company uses artificial intelligence to automate repetitive processes for hospital systems. The technology has been deployed in more than 600 hospitals across the country.
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Some hospitals are voluntarily halting elective care to prepare for a surge of COVID patients. President-elect Biden picks former Ebola Czar Ron Klain to be his chief of staff. And though millions lost job-based coverage during the pandemic, there wasn't a corresponding increase in the uninsured rate.
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North Dakota allows COVID positive nurses without symptoms to continue to work because hospitals are at capacity. Despite clear evidence that mask-wearing and social distancing can prevent the spread of COVID, some Americans are still ignoring health guidance. And Eli Lilly's antibody treatment gets emergency approval.
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Supreme Court justices heard the case challenging the Affordable Care Act on Tuesday. Based on lines of questioning from the nine justices during oral arguments, it doesn’t appear they are likely to strike down the entire healthcare law.
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Preliminary results from Pfizer show its coronavirus vaccine candidate is more than 90 % effective. President-Elect Joe Biden names top doctors and scientists to a COVID-19 task force. And a look at the first healthcare actions he could take as president.
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President-Elect Joe Biden will name top scientists and health experts to a COVID-19 task force Monday. The coronavirus crisis is deepening as cases and hospitalizations climb nationwide. And on Tuesday, the Supreme Court will hear a case challenging the Affordable Care Act.
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Some patients are now seeing COVID fees on their bills. According to a Bloomberg News analysis, counties with the most COVID-19 deaths per capita favored President Trump in the election. And the Department of Health and Human Services wants regulations to sunset every decade.
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Without decisive control of the Senate large-scale healthcare reform in the next two years seems unlikely. Hospitals are still reporting a tight supply of N95 masks, as daily COVID cases surpass 100,000. And across Europe, multiple countries reimpose lockdowns as cases soar.
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While votes are still being tallied in several swing states, results about healthcare-related ballot measures in California, Oklahoma, Oregon and the District of Columbia are in. And as cases and hospitalizations of COVID-19 continue to rise in several parts of the country, hospitals are struggling to find enough nurses.
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On Election Day, Gist Healthcare co-founders Chas Roades and Lisa Bielamowicz discuss how the outcomes could influence health policy for the next several years.
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Since the Affordable Care Act was signed into law a decade ago it has fundamentally reshaped the American healthcare system. The fate of the ACA is once again set to go before the Supreme Court on November 10. If the justices rule the law unconstitutional it could have far-reaching impacts on insurance coverage, consumer protections, hospital finances, and many other parts of our healthcare system.
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The FBI warns hospitals about ransomware attacks. As part of the Trump Administration’s price transparency efforts insurers will now have to share negotiated rates. And the government is requiring providers to list prices of COVID-19 diagnostic tests.
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Experts caution a COVID-19 vaccine may not be the pandemic panacea many are hoping for. Some European countries are worried about having enough nurses and doctors to treat rising numbers of COVID patients. And a study finds despite spending more time with patients female doctors are often paid less.
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Now that Amy Coney Barrett is a Supreme Court Justice, how will she rule on healthcare cases? Two large physician networks in Texas are joining together to pursue more value-based care contracts. Even though health officials have said a COVID-19 vaccine will be free, the details still need to be ironed out.
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Intermountain Healthcare and Sanford Health announced plans to merge. As COVID hospitalizations climb, some facilities don’t have enough healthcare workers. And Florida is trying to start a program to import drugs from Canada, but no companies want the job.
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Walmart Health Centers are springing up outside of Atlanta, GA, and providing "everyday low prices" for comprehensive primary care. In Georgia, some local providers are surprisingly welcoming of the new offering.
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President Trump and Vice President Biden squared off in the final 2020 presidential debate. Remdesivir receives full FDA approval. And pharmaceutical companies are using GPS, decoy trucks, and US marshals to protect a COVID-19 vaccine from thieves.
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The Justice Department reached an $8 billion settlement with opioid maker Purdue Pharma. Cases are spreading so fast in North Dakota, the state is asking people to contact trace themselves. And Nebraska gets approval for a two-tiered Medicaid system.
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Scientists in the United Kingdom plan to study the coronavirus by intentionally infecting people. Premiums for those buying coverage on Healthcare.gov will decrease an average of 2 percent And Asia has been able to keep COVID outbreaks under control while the West is still struggling.
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With coronavirus cases increasing to levels not seen since the summer, the Trump administration's plans to contain the spread are unclear. Pfizer won’t be ready to seek emergency approval for a COVID-19 vaccine until mid-November. And early testing programs in New York City schools are showing low case numbers.
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Gist Healthcare's Jennifer Stewart talks with Senior Governance Advisor and former CEO of Jacksonville, Florida based Baptist Health Hugh Greene. He shares insights and lessons learned from leading a health system board for almost two decades and opportunities for health system executives to further strengthen governance.
Read more of Jennifer's insights on Gisthealthcare.com
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During Thursday night townhalls, presidential candidates talked about coronavirus response plans, but little about future healthcare reforms. A ProPublica investigation, details how the White House has exerted influence over the CDC throughout the pandemic. And Georgia has federal approval for a limited Medicaid expansion.
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Harvard economists estimate the coronavirus will cost the US economy $16 trillion. Laboratories are having a hard time finding enough technologists. And seniors may not get those discount prescription cards President Trump promised, until after election day.
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Trials for a coronavirus treatment and vaccine were halted for safety concerns. Children are still delaying medical care, and Children's hospitals are hurting. With adults and kids delaying care, insurers are making healthy profits.
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Democrats focused on healthcare during Judge Amy Coney Barrett’s first confirmation hearing for the Supreme Court. The NBA’s bubble is a coronavirus success story. And new data is showing K-12 schools may not be the superspreader environments some thought they could be.
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As the cost of job-based health insurance has increased over the past decade, many employers are continuing to shift those costs to employees. Centivo CEO Ashok Subramanian discusses how the recession caused by COVID is already pushing some companies to seek out new and lower-cost health insurance options.
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Steve Lefar, Executive Director of Strata Decision Technology, says health systems need to get used to the new normal of lower patient volumes. The company’s recent analysis of hospital data shows patients' behavior has changed, and hospitals can’t count on volumes returning to pre-pandemic levels.
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Vice presidential candidates talked about two different coronavirus realities during the debate. Despite years of warnings, an AP and PBS Frontline investigation found the US didn’t take adequate steps to secure a domestic medical supply chain. And for the first time, two women win the Nobel Prize in chemistry.
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Senator Kamala Harris and Vice President Mike Pence are set to debate tonight in Utah. Insurance startup Clover Health is going public. And the FDA publishes stricter COVID vaccine approval guidelines.
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After four days in the hospital for COVID-19, President Trump returns to the White House. The Centers for Disease Control and Prevention acknowledges that COVID can be spread through the air. And insurers are expanding Medicare Advantage offerings for the 2021 plan year.
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The Supreme Court is set to hear a case about states' power to regulate pharmacy middlemen. Leslie Walker with the health policy podcast Tradeoffs says a ruling could end up impacting states' ability to regulate healthcare.
To listen to the full Tradeoffs episode, which goes into more detail about the case, go to Tradeoffs.org or download it wherever you get your podcasts.
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Hospitals will now get the COVID treatment remdesivir from the drugmaker and distributor rather than the government. The stop-gap government funding measure relaxes Medicare loan repayment terms. And a Lousiana-based Ochsner Health is merging with another Louisiana hospital system.
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The federal government is sending millions of COVID test to states. Insurers are reducing telehealth benefits. And we dig into the details of Biden’s healthcare proposal.
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We learned little about either presidential candidate's healthcare plans during the first debate. The world reaches a grim milestone, more than one million people have died from COVID-19. And as federal business aid runs out, many more could lose health insurance.
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A social media site has emerged as an unlikely hero in the fight against vaccine misinformation. Concerns grow over conflicts of interest at a panel overseeing vaccine safety. And some psychologists say that when it comes to the COVID-19 death toll, Americans have an empathy problem.
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Gist Healthcare co-founders Chas Roades and Dr. Lisa Bielamowicz discuss how health systems and providers are building on telehealth gains made during the pandemic.
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New York sets up its own COVID-19 vaccine safety review committee. Walmart is delivering COVID-19 tests with drones. And President Trump says he’s sending seniors discount cards for prescription drugs.
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Inside hospitals, there’s a debate about whether the coronavirus is airborne. The head of the FDA says science will dictate any COVID-19 vaccine approval. And Indiana opens restaurants, bars, and allows sporting events to resume.
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The House passed a bill that would keep the government funded and relax medicare loan repayment terms. The CDC walks back guidance saying the coronavirus is airborne. Nurses at an HCA Healthcare hospital North Carolina vote to unionize.
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Justice Ruth Bader Ginsburg’s death leaves the fate of the Affordable Care Act uncertain. Black physicians create a panel to review a COVID vaccine. And advances in ICU care are helping COVID patients survive.
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Dr. Rushika Fernandopulle, co-founder and CEO of the value-based primary care organization Iora Health discusses how COVID led practices to reorganize around the patient, instead of the physical office.
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On the West Coast, the smoke is everywhere, even inside hospitals. COVID affects men and women differently but yet few studies breaking down outcomes by sex. And Cigna has become much more than a payer, and it’s rebranding.
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The head of the CDC says politics are not compromising scientific reports. More research reveals troubling racial disparities in COVID outcomes. And Medicare Advantage is revamping how it calculates payments for enrollees.
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A new Wall Street Journal report sheds light on hospital-acquired COVID infections. Apple unveils its new watch that can read blood oxygen levels. And the Centers for Medicare and Medicaid Services pulls back a controversial Medicaid financing rule.
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Lawmakers are investigating allegations that political appointees interfered with CDC reports. The head of a large vaccine manufacturer warns that it will be years before there’s enough for everyone to get inoculated. And the president signs another executive order to try and lower drug prices.
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We have data at our fingertips to figure out the best restaurant or when our takeout will be delivered, but as Dr. Daniel Stein says we don’t have nearly as much information about where to get surgery. Stein founded Embold Health to fix that and he discusses how the company uses data to help big companies send their employees to the best local providers.
To take the 5 question podcast survey go to GistHealthcare.com/survey
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The Senate failed to pass a fifth coronavirus relief package. Some hospitals and nursing homes are under fire for not isolating COVID patients. And hard hit by the pandemic, physician staffing firm Mednax is selling its radiology practice.
To take the anonymous Gist Healthcare Daily podcast survey go to Gisthealthcare.com/survey
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Many in America’s largest cities haven’t been able to get healthcare during the pandemic. The fight between hospitals and drugmakers over discounts is heating up. And AstraZeneca had to stop it’s COVID-19 vaccine trial while it investigates an adverse outcome.
To take take the podcast survey go to Gisthealthcare.com/survey
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Pharmaceutical companies are pledging their commitment to safety amid fears about politics interfering with the approval of a COVID-19 vaccine. As schools and daycares resume, it’s hard for young kids to get a coronavirus test. And the Sturgis Motorcycle rally turned out to be a super spreader event.
To take take the podcast survey go to Gisthealthcare.com/survey
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David Jarrard, CEO of strategic communications firm Jarrard Phillips Cate & Hancock, discusses new survey results about trust in the medical community and patients willingness to get a coronavirus vaccine or return to care.
To take the Gist Healthcare Daily podcast survey go to gisthealthcare.com/survey
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States are told to get ready for a COVID-19 vaccine as soon as next month. Hospitals will be required to reveal the rates they negotiate with Medicare Advantage insurers. And Georgia has a plan to leave Healthcare.gov.
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The US will not participate in the global vaccine effort. Multiple studies show low-cost steroids are a good treatment for critically ill COVID-19 patients. And the Wall Street Journal reports the government is going to start calling out hospitals for not reporting COVID metrics.
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A National Institutes of Health panel says there’s not enough evidence for convalescent plasma as a COVID-19 treatment. The government is speeding up Medicare’s coverage of new medical devices. And Apple and Google take a more active role in contact tracing.
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Despite the Trump Administration’s plan to cover COVID-19 care for the uninsured, some are still getting bills. Coronavirus is disrupting all kinds of medical education. And CVS expands its health plan offerings in concert with HealthHubs.
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We are airing an episode from the health policy podcast Tradeoffs titled "Core to Who I Am"
The Tradeoffs team dug into the history of how healthcare organizations discriminated against transgender patients prior to the landmark protections included in the Affordable Care Act—which are now being fought over in the courts.
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Amid criticism for the CDC's new coronavirus testing guidance, the president announces the country will buy 150 million new rapid antigen tests from Abbott Laboratories. A new study gives clues as to why men are harder hit by COVID. And Amazon launches a new fitness tracker.
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The CDC quietly changed it’s guidance on COVID testing. Hospitals backed by private equity firms make more than non-PE owned hospitals. And the pharmaceutical industry has its own plan to lower drug prices.
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At the Republican National Convention, speakers president praise for expanding telehealth and fast-tracking experimental COVID-19 treatments. Nursing homes, hospitals, and laboratories will need to start reporting metrics to Medicare or face fines. and Amwell gets a big investment from Google.
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President Trump announced temporary approval of convalescent plasma as a COVID treatment. Hospitals have continued to sue patients for unpaid medical bills even during the pandemic. And the first documented case of someone getting coronavirus for a second time comes from Hong Kong.
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Gist Healthcare co-founders Chas Roades and Dr. Lisa Bielamowicz talk about how COVID-19 is accelerating consolidation, payer-provider integration and digital health innovation. They’ll also share their thoughts on how demand for healthcare is likely to change in the wake of the pandemic.
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The government is making more changes to the hospital data reporting system. Pharmacists are now able to vaccinate kids. And some healthcare workers still having trouble getting masks and other personal protective gear.
Are you or your organization having trouble getting masks, face shields, or other PPE? We’d like to hear from you. Leave Gist Healthcare Daily a voicemail about your experience at 202-810-2843.
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The Supreme Court will hear the case challenging the Affordable Care Act one week after the November election. The World Health Organization says the pandemic is in a new stage primarily driven by young adults. And some people are reporting being severely ill with COVID-19 for several months.
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Democratic and Republican governors join together to get COVID tests. Post office changes were causing delays in prescription home deliveries. And employers are expecting healthcare costs to rise next year - driven partially by virtual care growth.
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In part two of our conversation with Travis Messina, CEO of hospital-at-home company Contessa, he says the biggest challenge to scale is a lack of reimbursement. Messina is confident traditional Medicare is close to paying health systems for treating patients with the model.
Read more of Gist Healthcare's insight into the hospital-at-home model.
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Travis Messina, CEO of hospital-at-home company Contessa, talks about the growing popularity of the model, the challenges of building a program, and the culture shift it requires. He compares the hospital-at-home model’s potential to that of early ambulatory surgery centers, which performed only a handful of procedures until Medicare expanded coverage and reimbursement.
Read more of Gist Healthcare's insight into the hospital-at-home model.
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Russia approves a COVID-19 vaccine before finishing clinical trials. Daily coronavirus deaths climb following outbreaks in the Sun Belt state. And telemedicine visits may have plateaued.
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Norfolk, VA-based Sentara Healthcare and Greensboro, NC-based Cone Health announced plans to merge. And two news organizations are tracking healthcare workers dying from COVID-19 and finding some troubling trends.
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Researchers found some commonly worn masks are actually counterproductive. Joint replacements were some of the most profitable procedures for hospitals - but how fast will they come back after COVID? And The details of Medicare's rural healthcare pilot program are out.
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The lack of a coronavirus relief package leaves a lot of healthcare policies up in the air. Companies are hiring healthcare experts to deal with COVID safety. And during the pandemic doctors found themselves asking where are all the premature babies?
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In his new book The Riches of This Land, New York Times Economics Reporter Jim Tankersley talks about how minorities have been disadvantaged by American economic policy and are being harder hit by the COVID-19 induced recession. Tankersley says women and men of color are key to rebuilding the country's middle class.
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The president is now ordering federal agencies to buy certain medicines and supplies from American factories. A study sparked a social media firestorm raising questions about professionalism in healthcare. And experts warn global shutdowns have put millions of lives at risk due to other infectious diseases.
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Missouri voters decide to expand Medicaid. Medicare announces plans to eliminate inpatient-only lists. And a big virtual healthcare merger is announced between Livongo and Teladoc Health.
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Israel warns the U.S. opening schools too quickly can have disastrous consequences. Next year, Medicare is planning to boost what it pays primary care doctors and lower what it pays some specialists. And rural parts of America, which are now seeing rising numbers of coronavirus cases have a lot fewer ICU beds.
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Hospitals are taking big hits to revenue but only some are cutting executive pay. Over the last two months, the uninsured rate jumped by 12 percent. And President Trump wants to keep telehealth gains achieved during the pandemic.
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On Tuesday, Missouri will decide whether or not to expand Medicaid. Missouri is the second state to make this decision in the midst of the COVID-19 pandemic which has caused millions to lose their jobs and has brought the importance of medical care to the forefront.
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The American economy contracted the most it has in modern history during the second quarter of 2020. Coronavirus vaccine development is moving at a dizzying pace. And Oscar Health builds on telehealth popularity with an unlimited virtual primary care option.
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Closing schools in the spring likely saved 40,000 lives according to one study published in JAMA. Vice President Joe Biden's healthcare platform moves beyond just expanding the ACA. And the pandemic has been a boon for home-based care companies.
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Pharmaceutical executives canceled a White House meeting days after the president's drug pricing orders. Providers are hoping Congress will delay Medicare repayments. And now you can register to vote - in the waiting room.
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Republicans lawmakers unveil a coronavirus stimulus package which includes cuts to unemployment assistance. The third and final phase of a potential COVID-19 vaccine begins. And COVID-19 has now surpassed strokes as the fifth leading cause of death in the United States.
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Dr. Rahul Rajkumar, Chief Medical Officer of Blue Cross Blue Shield of North Carolina talks about the insurer’s new efforts to shore up independent primary care practices. And one Charlotte doctor says he’s looking forward to the greater predictability he’ll gain through the program.
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President Trump cancels the Republican National Convention event in Florida, as the state hits record daily COVID-19 deaths. New reporting requirements create extra headaches for hospitals dealing with outbreaks. And nursing homes will need to test staff more often.
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Despite halts on elective surgeries, HCA Healthcare posted $1.1 billion in second-quarter profits. Researchers try to figure out just how deadly the coronavirus is. And the government agrees to pay Pfizer nearly $2 billion dollars for a COVID-19 vaccine.
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President Trump restarted daily coronavirus briefings as US cases hit 3.8 million. Antibody tests show COVID-19 infections are much more widespread than reported. And states are challenging the Trump Administration's rollback of ACA nondiscrimination protections.
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Three potential COVID-19 vaccine candidates show promising results. Quest Diagnostics got federal approval for pool testing. And courts side with the Trump Administration on site-neutral payments and short term health plans.
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Torben Nielsen, CEO of Zoom+Care, talks about how the urgent care chain with clinics in Oregon and Washington has handled the explosive growth of virtual care during the COVID pandemic. Nielsen says it’s caused Zoom+Care to rethink whether opening more physical clinics is necessary to serve more patients, or whether telemedicine opens up a new path to growth.
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This rerun is part of our "best of" week featuring some of our favorite conversations over the last year. Gist Healthcare's Director of Member Insight Michael Cuello talks about "triple-threat" counties, places with multiple types of "superspreader" facilities like nursing homes, correctional facilities, and meatpacking plants. Check out Gist's graphic about COVID-19 Outbreak Risk in Counties with "Superspreader Facilities".
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This rerun is part of our "best of" week featuring some of our favorite conversations over the last year. In her new book "Marching Toward Coverage", Rosemarie Day calls on women to engage more actively in the debate over universal coverage. Day helped lead Massachusetts’ health insurance reform under then-Governor Mitt Romney and is currently the CEO of healthcare consulting firm Day Health Strategies.
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This rerun is part of our "best of" week featuring some of our favorite conversations over the last year.
Physician and former Chief Medical Officer for a Division of HCA Dr. Dick Hamrick says healthcare price transparency important for doctors as well as patients, as this cost information could help inform treatment decisions.
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This rerun is part of our "best of" week featuring some of our favorite conversations over the last year.
Dr. Connie Lehman, Chief of Breast Imaging at Mass General Hospital and Professor of Radiology at Harvard Medical School, is using AI models to read mammograms and working to share the technology with other countries that have limited access.
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This rerun is part of our "best of" week featuring some of our favorite conversations over the last year.
Dr. David Asch, a behavioral economist and the executive director of the Penn Medicine Center for Health Care Innovation says as people come out of lockdown they have different needs and safety concerns, and businesses are going to have to adapt.
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Note to listeners: Our podcast will be on holiday hiatus next week. Make sure to tune in Monday, July 13, for a week of “best of”—our favorite conversations with healthcare innovators. The regular podcast will return with new episodes on July 20th.
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Mortality rates for COVID-19 vary wildly between private and public hospitals in New York City. The FDA will not approve a coronavirus vaccine unless it's proven effective, and the country’s decimated public health system faces morebudget cuts.
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Top Republicans plead with the president to wear a mask. The nation's top infectious disease official warns coronavirus infections could soon top 100,000 a day. And Democratic Presidential Candidate Joe Biden called for a more comprehensive COVID response.
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Gilead Sciences is charging American patients with private insurance more than $3,000 for its COVID-19 treatment. ICU beds in COVID hot spots across the South and West are filling up and demand for COVID tests is quickly outpacing supply.
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Former CEO of Houston based Memorial Hermann Health System and current partner at Relia Healthcare Advisors, Chuck Stokes says the pandemic has exposed how fragmented acute care is from the public health infrastructure. He believes that new healthcare positions will continue to be created to help connect the two systems.
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Experts believe coronavirus infection rates are 10 times the number of confirmed cases. Blue Cross Blue Shield of North Carolina is trying to help independent practices get through the pandemic by changing how they are paid. And local officials are finding the virus is spreading through parties, not protests.
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Daily coronavirus cases are hitting levels not seen since April. Insurers don’t have to pay for return to work COVID-19 tests. And the Democrats introduce legislation to strengthen the Affordable Care Act.
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A judge rules the government can require hospitals to disclose negotiated prices with insurers. The nation’s top infectious disease official is optimistic about a coronavirus vaccine. And Avalere estimates COVID-19 hospitalizations could end up costing $17B this year.
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Lawmakers are calling for the Trump Administration to spend all of the coronavirus funding that was dedicated to testing and contact tracing. Local public health officials trying to contain the virus are facing threats. And COVID-19 cases are increasing at record rates across the globe.
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Gist Healthcare's Senior Vice President, Development Jennifer Stewart discusses challenges COVID-19 has brought to the healthcare workforce. She tells us the pandemic has uncovered ways the workforce has grown brittle and created revenue losses that will force health system leaders to reconsider labor costs, workforce flexibility, and automation.
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A Supreme Court ruling on DACA means thousands of medical workers can stay in the country. Congress weighs how to regulate telehealth post-pandemic. And patients who recovered from COVID-19 may not have antibodies for more than a couple of months.
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Two healthcare mergers are the signs of more to come, after months of pandemic-induced financial stress. Colorado was able to open up without large COVID-19 case spikes. And with rising unemployment, millions of Americans are at risk of losing insurance.
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British researchers found a widely available steroid helped the sickest COVID-19 patients. Tenet Healthcare says patients are coming back. And lawmakers are investigating why so many people are dying in nursing homes.
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Medically Home co-founder and CEO Raphael Rakowski and Chief Medical Officer Dr. Pippa Shulman discuss caring for COVID-19 patients through the hospital-at-home model and what the hospital of the future will look like.
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Medically Home co-founder and CEO Raphael Rakowski and Chief Medical Officer Dr. Pippa Shulman discuss hospital-at-home care, which has become increasingly popular during the coronavirus pandemic.
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COVID hospitalizations and cases surge across the country as states reopen. Safety net providers are finally getting some federal aid. And South Korea, which has been a global model for its coronavirus response, is seeing an uptick in cases.
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COVID tests are going to cost insurers billions. "The genie is out of the bottle on telehealth", said a top Trump administration health official. And face masks may be one of the best tools we have to prevent the spread of COVID-19.
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Gist Healthcare's Director of Member Insight Michael Cuello talks about "triple-threat" counties, places with multiple types of "superspreader" facilities like nursing homes, correctional facilities, and meatpacking plants. Check out Gist's graphic about COVID-19 Outbreak Risk in Counties with "Superspreader Facilities"
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Infectious disease experts worry that protests and reopening economies could lead to another surge in COVID cases. Hospitals that got federal stimulus dollars furloughed or laid off staff. And some patients are testing positive for COVID even after they recovered.
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General Partner at venture capital platform LRV Health Keith Figlioli says he's watching to see which regulations are reinstated, such as restrictions on telehealth, which could have a big impact on virtual care innovations.
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Dr. David Asch, a behavioral economist and the executive director of the Penn Medicine Center for Health Care Innovation says as people come out of lockdown they have different needs and safety concerns, and businesses are going to have to adapt.
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The CDC was caught flat-footed by the coronavirus pandemic. Scientists raise concerns about data behind two studies about COVID treatments. And private equity-backed healthcare companies got more than a billion dollars in CARES Act funding.
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COVID has claimed the lives of almost 26,000 nursing home residents, and staff. California’s Attorney General wants more regulatory authority over healthcare mergers. And Steward Health Care physicians buy back a controlling share of their company.
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Large protests in the wake of George Floyd’s death in Minneapolis are raising concerns about a spike in coronavirus cases. Oklahoma said it can no longer afford to expand Medicaid. And hospitals and physician practices are having trouble navigating CARES Act funding.
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As states lift restrictions and businesses start to reopen, many are turning to local health systems for guidance. Teke Drummond, the executive director of corporate partnerships for Penn Medicine HealthWorks at Lancaster General Hospital, said the system is helping businesses do temperature checks and take other preventive measures to stem COVID-19 outbreaks.
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What is the most accurate way to count COVID deaths? Belgium counts suspected cases. A third of American adults are reporting signs of depression or anxiety. And in Japan, strict social distancing has helped keep the outbreak under control.
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South Korea reports a spike in COVID-19 cases. Seniors will be able to buy prescription drug plans that cap out-of-pocket insulin costs. And despite the COVID vaccine race, almost half of American’s said they wouldn’t get the shot.
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Founder and CEO of Remedy Dr. Jeremy Gabrysch said the immediate care and telemedicine startup was well-positioned to deliver care in the wake of COVID-19, providing care digitally or in patients’ homes.
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Premier announced plans to invest in American manufacturing of protective gear. Insurers are starting to give profits back to customers. And dentists hard hit by halts on elective care, are trying to bring patients back.
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Patients are returning to doctor's offices. Now that the flood of COVID patients has subsided in New York City, hospitals are planning to treat other patients. And some states are arranging COVID statistics in ways that don’t accurately show the current level of infection.
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The government urged extreme caution when reopening nursing homes. A Virginia drug company got a large contract to bring more manufacturing onshore. And the CDC is working on a national antibody study.
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President Trump says he’s taking hydroxychloroquine despite warnings from the FDA. AdventHealth says the 35,000 COVID-19 tests it ordered are unreliable. Moderna reveals positive results from its phase 1 vaccine trial.
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Mayo Clinic's Director of Business Integrity and Continuity Dr. Erich Heneke is responsible for planning for catastrophes like COVID-19, and managing the system’s supply chain. Heneke is working to secure precious COVID-19 equipment, while also procuring more traditional supplies as Mayo resumes elective care.
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Despite having the all-clear from Georgia Governor Brian Kemp, to reopen some businesses are staying closed. Business owners told Gist they didn't feel it was safe to start interacting with customers.
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Many who lost jobs and health benefits will qualify for subsidies to buy a new health plan. Abbott Laboratories’ rapid COVID-19 diagnostic test could be missing as many as half of positive cases. And the latest stimulus package has another $100 billion in relief for providers.
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Dr. Fauci warns reopening the economy too early could have serious consequences. A new price transparency requirement is drawing ire from hospitals. And some hospitals want to be protected legally so patients can’t sue if they get coronavirus while in for a procedure.
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Dr. Atul Gawande is reportedly leaving his position as CEO of Haven. Studies are revealing how COVID-19 is affecting children. And the White House says it’s giving states funding to help ramp up testing.
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Founder of social determinants of health-focused investment firm Nightingale Partners and longtime managed care consultant John Gorman expects the pandemic to lead Medicare Advantage plans to offer more supplemental benefits to seniors.
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President Trump is still asking the Supreme Court to invalidate the Affordable Care Act. Many states are lifting lockdowns despite not meeting the federal criteria. And new research shows almost everyone who gets infected with COVID-19 develops antibodies.
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The pandemic is estimated to cost hospitals more than $200 billion. In a whistleblower complaint, a top federal scientist says he was dismissed for refusing to promote an unproven drug as a COVID-19 treatment. And with millions expected to sign up for Medicaid, states are making cuts.
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The White House is considering disbanding the coronavirus task force even as cases and deaths are expected to rise. The administration steps up its oversight of antibody tests. And health systems are telling patients it’s safe to come back.
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As states ease lockdowns, updated models predict many more Americans will die from COVID-19. Hospitals and doctors are asking Congress to turn Medicare advanced payments into forgivable grants. And states join together to buy medical supplies.
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Former Cigna executive-turned-industry-observer Wendell Potter talks about how the pandemic will alter the insurance market. Potter expects rising 2021 premiums will drive more employers away from offering health benefits. He is also watching to see if insurers acquire physicians hard-hit by drops in patient volume.
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South Korea reached a big milestone - no new locally spread COVID-19 cases. Providers are adopting telehealth fast, but payment is still a problem. And insurers are painting a rosy picture for investors, yet asking for federal aid.
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Early study results show remdesivir helped COVID-19 patients recover faster. The economy shrank by 4.8 percent in the first quarter of 2020. And young healthcare workers on the front lines are struggling to treat COVID-19 patients.
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Oncologists are concerned delayed cancer care will lead to more advanced disease. Quest Diagnostics has a new direct-to-consumer antibody test. Both wealthy and struggling hospitals compete for the same federal funds.
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Americans are delaying emergent medical care. Public health experts say COVID-19 testing needs to be one part of a strategy to reopen the country. And the Supreme Court ruled the government owes insurers $12 billion it had promised.
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Dr. David Carsten talks about how COVID-19 is impacting dentistry and upending the live-patient licensure requirement, which is now being transitioned to an exam.
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The head of the nation's vaccine development agency says he was removed for pushing back on a treatment the president supported. Doctors are concerned about the connection between COVID-19 and blood clots. And governors develop a detailed roadmap for reopening states.
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As hospitals gear up to bring elective procedures back the question is whether patients be ready. The coronavirus may have a resurgence in the fall, just as flu season starts. And hospitals in COVID hotspots will get federal aid.
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Nurses are protesting unsafe working conditions. Envision Healthcare is reportedly considering filing for bankruptcy. And HCA Healthcare reports big drops in inpatient and outpatient surgeries.
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Hospitals get the green light to start bringing back elective surgeries with a few conditions. Supplies, accuracy, and availability are still hampering widespread testing efforts. And congress nears a fourth coronavirus aid deal.
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Dr. Charles Dennis, Chief Medical Officer at the Carle Foundation discusses how engineers and medical professionals at the Urbana, IL-based health system are working together to develop medical equipment for COVID-19 patients.
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President Trump says as early as today states that meet requirements can start to reopen. There are now reports that COVID-19 affecting patients' kidneys. And the healthcare sector lost more than 40,000 jobs in March.
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President Trump cuts funding to the World Health Organization. Harvard researchers say some form of social distancing could continue for two more years. And insurer UnitedHealth Group beat earnings estimates in the first quarter.
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Hospitals say federal emergency aid isn’t being distributed based on need. Healthcare workers treating coronavirus in India are getting attacked. And a Blue Shield of California company acquires a large physician group.
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Two drugs the President has cited as promising treatments for coronavirus are showing disappointing and even some dangerous results. To reopen the country experts say we need a team of public health workers. And insurers have to cover antibody tests with no cost to patients.
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Politico's Dan Diamond discusses his recent reporting about how infighting and chaos within the Trump administration are impacting the coronavirus response.
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According to a Gist Healthcare analysis, even primary care practices that moved most care online will still lose a lot of revenue. And Catalyst Health Network CEO Dr. Christopher Crow urges commercial payers to change the way they pay for care.
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The government is reportedly seizing shipments of medical supplies from hospitals. Hospital care for uninsured patients could top $40 billion. And in Michigan, hospitals are struggling as staff are getting sick.
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Privia Health CEO Shawn Morris and Chief Clinical Officer Dr. Keith Fernandez discuss how the national physician group is helping practices adapt care during the pandemic.
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Primary care advocates are calling on commercial insurers to overhaul how they pay for care. Italy considers testing for COVID antibodies to determine who can go back to work. And hospitals are calling on insurers to follow Medicare’s lead and offer advanced payments.
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In her new book "Marching Toward Coverage", Rosemarie Day calls on women to engage more actively in the debate over universal coverage. Day helped lead Massachusetts’ health insurance reform under then-Governor Mitt Romney and is currently the CEO of healthcare consulting firm Day Health Strategies.
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Should negative COVID test results be trusted? As jobless claims top six million, the Trump administration decides not to reopen healthcare.gov. And public health officials are reconsidering whether everyone should now wear face masks.
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Medicare offers advanced payments for hospitals and providers short on cash and expands telehealth coverage. Hospitals around the country furlough staff. And surgery centers are turned into hospitals.
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Chief of Cardiology at the University of California San Francisco Dr. Jeff Olgin talks about a new COVID-19 mobile research study to track early symptoms, risk factors, and community transmission.
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Chief Operating Officer and Co-Founder of Upfront Healthcare Carrie Kozlowski, talks about how the digital platform has been able to respond to the needs of the healthcare system during the pandemic and quickly disseminate trusted information to patients.
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New York City Family Medicine Dr. Bertie Bregman is treating a lot of patients with COVID-19. He talks about how his practice has changed during the pandemic and what the future holds.
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Steve Lefar with Strata Decision Technology discusses how the COVID-19 pandemic will impact hospital margins.
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Dr. Nick Zenarosa, CEO and founder of Texas-based Integrative Emergency Services, discusses challenges for emergency medicine doctors dealing with the COVID-19 pandemic.
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Dr. Farzad Mostashari, CEO and co-founder of Aledade talks about how primary care practices are struggling during the pandemic as patients stay home and cancel appointments.
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A rapid COVID-19 test is developed that gives results in less than an hour. One doctor shares a method to use one ventilator for multiple patients. And South Korea’s tiered care approach frees up hospital space.
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Mount Sinai Health System's Chief Product Officer David Kerwar talks about how the New York City-based system adapted its digital flu screening tool for COVID-19.
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The number of COVID-19 climbs in the United States as testing ramps up. Health systems are asking congress for $100 billion in emergency assistance. And more coronavirus news.
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Dr. Asaf Bitton talks about the importance of social distancing and what Ariadne Labs is working on to help health care workers during the COVID-19 pandemic. And an update on the latest coronavirus news.
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A health system dedicates a hospital to treating COVID-19 patients. The government expands telehealth coverage for seniors. And hospitals are concerned about ventilator shortages.
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Chief Medical Officer of Zoom+Care Dr. Erik Vanderlip says the innovative urgent care chain is relying heavily on telemedicine during the coronavirus pandemic. And an update on the latest coronavirus news.
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Julie Barnes, founder of Maverick Health Policy, says the new health information sharing rules are as transformative to the health care industry as ATM was to the banking industry. And an update on the latest coronavirus news.
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Delays in coronavirus testing may be masking the true number of cases. Presidential candidates criticize the Trump administration’s response to the pandemic. And many health systems are working with tech companies to store patient data.
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The coronavirus is now officially a pandemic. President Trump announces new travel restrictions for Americans to try and slow the spread of the disease. And Medicare plans to cap insulin costs.
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Diagnostic errors are the leading patient safety concern. The American Heart Association pulls aspirin displays. And public events are being canceled to slow the spread of coronavirus.
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Patients will be able to get their healthcare data and share it with apps thanks to new data-sharing rules. Hospitals are bracing for an influx of coronavirus patients. And specialists are feeling pressure to accept lower rates or go out-of-network.
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Former U.S. Chief Technology Officer Aneesh Chopra shares his thoughts on efforts by the Trump administration to ensure consumers have free access to all of their health data. And an update on the latest healthcare news.
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World health officials say it's time to pull out all the stops to fight the coronavirus. Lawmakers want more answers about Project Nightingale. And insurers are starting to pay doctors to help patients with their social needs.
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Congress reached a deal on emergency coronavirus funding. Insurers and hospital stocks were up after Super Tuesday results. And a federal judge puts Medicaid work requirements in Michigan on hold.
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Health care was at the top of voters' minds on Super Tuesday. Alexa can now tell you about medication side effects. And UnitedHealth Group is offering low-cost plans if you see one of the company’s doctors.
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The Supreme Court will hear the case challenging the Affordable Care Act before the 2020 election. President Trump is set to address new health IT rules at the HIMSS conference. And Washington authorities scramble to contain the spread of coronavirus.
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The first two coronavirus related deaths are reported in the US. Walmart continues to boost its health offerings. And we hear how private equity investment in specialists could be a threat to health systems.
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Fears of coronavirus grow in the U.S. A look at an unorthodox group of doctors. And new research aimed at gun violence prevention.
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The nation is watching as Colorado releases details on a public option proposal. Short term plans are leaving sick patients on the hook for expensive care. And the government wants to crack down on accrediting organizations.
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Health officials warn it’s just a matter of time before coronavirus starts spreading in the US. And Democratic presidential candidates take the stage before Super Tuesday.
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Insurer owned clinics are a growing threat to hospitals. Growing Medicare Advantage membership drives insurer profits. And new companies are selling prescriptions directly to consumers.
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The Medicare for All candidate wins the Nevada caucuses. Congress gets an update on the global coronavirus response. And a researcher investigates how well providers are integrating spending on social determinants of health.
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Millions are still turning to strangers to help pay their medical bills. Recent studies show mental shortcuts are affecting the way doctors treat patients. And scientists say the flu vaccine is 45% effective.
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The public option is popular among Democratic presidential candidates and the American public. 2019 was the worst year for rural hospital closures. And a new study quantifies the rate of private equity investment in physician practices.
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One study finds hospitals making the most profit are providing a disproportionately low amount of charity care. State laws limiting out of pocket costs for insulin exclude a lot of patients. And long term care costs for seniors are ballooning.
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An appeals court strikes another blow to the Trump Administration's Medicaid work requirement policy. The founder of the new Public Option Institute explains how he is evaluating the implementation and impact of plans in Washington and Colorado.
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Coronavirus cases around the world rise to more than 60,000. Lawmakers want to extend health care transparency initiatives to private equity firms. And Google Health is growing.
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Lawmakers are demanding answers about why organs meant for transplant patients are ending up in the trash. Surprise billing legislation favored by doctors and hospitals advances out of committee. And a year after CVS Health acquired Aetna, the company is seeing the benefits.
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While new surprise billing fixes are debated in congress, a new study finds 1 in 5 patients are getting these bills. And insurers have their own price transparency proposal.
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President Trump’s budget includes big Medicaid cuts. Authorities in multiple countries are looking into Google’s purchase of FitBit. And Utah is saving money on prescription drugs by paying for patients to get their scripts filled in Mexico.
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With new surprise billing legislation, the debate about the practice is expected to heat up again. And the final health information sharing rules are expected soon. One expert tells Gist, the rules may be the biggest single health reform she’s ever seen.
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Experts say adding your own language to hospital contracts could offer some protection against surprise medical bills. A ban on certain types of e-cigarettes is now in effect. And Cigna boasts the lowest medical cost growth in the industry.
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A group of bipartisan health experts is out with a health care plan. The Supreme Court may again consider taking the case challenging the Affordable Care Act. And lawmakers want more control over the Innovation Center.
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Health care providers are struggling to spend effectively on social services. The former CEO of Aetna is off the CVS Health board. And fewer people are visiting their primary care providers.
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Pharmacists at big retail chains say crushing workloads are put patient safety at risk. The number of nurse practitioners has more than doubled in the last decade. And Humana opens more primary care clinics with a large private equity investment.
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New federal regulations around the way states finance their Medicaid programs could have huge implications. Partner at policy advisory firm Manatt Health Anne Karl explains just how much hospitals and states stand to lose.
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The federal government is offering states more flexibility on Medicaid in exchange for limited funding. The coronavirus is now an official public health emergency. And Americans are living longer
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Close to 8,000 health care workers go on strike in Seattle disrupting patient care and costing the hospital millions. And some lawmakers are renewing calls for legislation to address surprise billing.
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Practice Fusion will pay a hefty fine for a kickback scheme to prescribe more opioids. Illinois passes a law to make insulin more affordable. And coronavirus cases continue to increase across the globe.
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Self-insured employers aren’t reducing healthcare costs. Secretary of Health Alex Azar says "scare tactics" won’t stop plans to ease medical records access. And the Supreme Court says the public charge rule can be enforced.
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More cases of coronavirus are identified in the United States. Congressman Pete Stark, who was involved in pivotal health policies died at age 88. And Dan Gorenstein talks about exploring the tradeoffs of healthcare policy in his new podcast.
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Cardinal Health recalls 9 million surgical gowns. Blue Cross Blue Shield and Civica are partnering to make affordable generic drugs. And the president says he’s now considering cuts to Medicare.
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There’s at least one coronavirus case in the United States. Centene plans to close its acquisition of WellCare this week. And one report paints the federal government is one of the fiercest medical debt collectors.
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The Supreme Court will not hear the case challenging the Affordable Care Act. And a radiologist addresses the fears within the field about being replaced by artificial intelligence which is getting better at reading mammograms.
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A large physician group throws its support behind Medicare for All. Artificial intelligence models are being developed to identify breast cancer – and Dr. Connie Lehman believes this could help make mammograms more accessible for women worldwide.
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Wyoming can’t use Medicaid to regulate air ambulance prices. Controversy over dietary guidelines about red meat continues. And the Affordable Care Act narrowed racial health disparities.
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Many young women got unnecessary pelvic exams and Pap tests. UnitedHealth Group had record Medicare Advantage growth. And CVS says it's clinics can treat the majority of what people go to primary care doctors for.
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Experts say no need to wear protective aprons during x-rays. Physicians spend 16 minutes on electronic health records after each patient visit. And Democratic candidates say the government needs to take a role in reducing prescription drug prices.
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A new biotech company plans to make lower-cost branded drugs. Two of President Trump's healthcare initiatives are back in court. And retiring CEO of St. Luke's Health System Dr. David Pate says the way to reign in healthcare spending is to get rid of low-value care.
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The Justice Department says it's premature for the Supreme Court to hear the case challenging the Affordable Care Act. And outgoing CEO of Boise, ID-based St. Luke’s Health System, Dr. David Pate reflects on his tenure which included an aggressive transition to value.
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Focused medical and social help for the sickest patients didn’t keep them out of the hospital. California announces a plan to contracting directly with generic drug makers to lower prices. And health insurance sign-ups remain stable for 2020.
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Single-year cancer deaths decreased at a record rate. Walgreens Boots Alliance stock dropped after worse than anticipated first-quarter earnings. And research finds bundled payments have some savings limited to a few procedures.
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Does a tax on vaping products lead people to keep smoking cigarettes? In the last 20 years, hospital charges have skyrocketed. And the government plans to rely more on data from doctor visits to determine much to pay Medicare Advantage insurers.
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One Medical announced it's going public. Democratic states ask the Supreme Court to take the case challenging the Affordable Care Act. And one medical school fed up with a popular ranking system says it's pulling out.
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In the debate, Democratic presidential candidates spend just a few minutes on healthcare. Fewer Americans have primary care doctors. And one Boston union finds a way to lower premiums and increase wages.
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A federal appeals court ruled the Affordable Care Act's individual mandate is unconstitutional. The order sends the case back to the lower court to decide which parts of the law can remain. Duke University Professor of Law and Business Barak Richman explains what the decision means.
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The first state to get federal permission to add Medicaid work requirements – ends them. The end of the year spending bill includes repeals of three Affordable Care Act taxes. And to deal with an organ transplant and donation shortages the government proposes new rules.
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CMS extended the open enrollment period for those buying coverage on the federal marketplace. One study finds measures to stop surprise billing could save 40 billion dollars a year. And former NFL players are charged with a healthcare fraud scheme.
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Advocates are calling for an open enrollment extension because of outages to Healthcare.gov. CMS says it will pay hospitals back for site-neutral payment cuts. And Gist dives into the details of the new Medicare Direct Contracting model.
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The House passes a bill to lower prescription drug prices. A new proposal to stop surprise billing has thrown a wrench into plans to pass legislation by the end of the year. And a report finds insurers may be making Medicare Advantage patients appear sicker to get more money.
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A House vote on Pelosi's drug pricing bill is expected Thursday. Two of the president’s top health officials are headed to the White House to resolve an ongoing feud. And the Justice Department reportedly opens a probe into Google’s purchase of Fitbit.
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House Speaker Nancy Pelosi compromises with progressive democrats on drug pricing legislation ahead of a vote. Civica Rx announces it will have eight generic drugs shipped by the end of the year. For the first time, female medical students are the majority.
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The Supreme Court will hear a case insurers say is about the integrity of the federal government. Details of the surprise billing compromise lawmakers reached over the weekend are coming out. And House Republicans introduce another drug pricing bill.
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A bipartisan group of lawmakers reached a deal on surprise billing legislation. This week lawmakers hold a hearing on proposals for universal coverage. And we talk to Dan Weissmann, host of the podcast, An Arm And A Leg, about the cost of healthcare.
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Nearly one in three high schoolers report having used one form of tobacco. Lawmakers are considering how to regulate all the health data from Fitbits and Apple watches. And one report finds value-based care initiatives haven’t made people that much healthier.
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Hospital groups are taking the Trump administration to court over its price transparency rule. Unable to stop robocalls from inundating their phone lines, hospitals are turning to Congress for help. And Virginia presses pause on Medicaid work requirements.
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Accountable Care Organizations are saving Medicare money – but reports differ on how much. Healthcare giant UnitedHealthGroup is going to get even bigger. During Medicare open enrollment, few people actually switch plans.
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A private equity-owned physician staffing company says it will stop suing patients over unpaid bills. Amazon releases a medical transcription tool. And a study finds one in five teens and one in four young adults have prediabetes.
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On this special episode, all six parts of our North Carolina series. Gist Healthcare spoke with changemakers across the state as public policy change and private sector disruption play out across the state.
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Now consumers of Giant Eagle grocery stores can ask Alexa to refill their prescriptions. A federal judge blocked President Trump's requirement that immigrants buy health insurance or prove they can pay for their own care. And opioid makers and distributors are now part of a criminal probe.
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A new Texas law to protect patients from surprise medical bills has a loophole. Patients in another state sue over impending Medicaid work requirements. And UnitedHealthcare and Walgreens partner to open Medicare service centers in stores.
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Hundreds of hospitals sue over cuts they say have continued past their expiration date. Another medical school offers free tuition to students if they agree to work in underserved areas. In our final North Carolina story, we hear about an organization that's bringing primary care doctors together.
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A cut to hospitals was again delayed as part of a larger spending bill. Medicare’s new enrollment tool isn't making out-of-pocket drug costs clear. As part of the North Carolina series, we explore how the largest purchaser of care in the state is trying to get price transparency.
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Healthcare was only briefly mentioned by Democratic presidential candidates in the debate. The largest physician association took positions on e-cigarettes and conversion therapy. And in the fourth part of our North Carolina series, a primary care doctor says he’s more confident than ever in his decision to stay independent.
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North Carolina's move to Medicaid managed care is on hold. Federal lawmakers voted to again delay hospital funding cuts. As part of our North Carolina series, Cone Health CEO Terry Akin talks about how moving to value has changed the way the system approaches patient care.
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Blue Cross plans are creating a nationwide network. A study finds medicines may be just as effective for some patients with stable heart disease as surgery to prevent heart attacks. And as part of our North Carolina series, we hear from Blue Cross Blue Shield about its plans to move to shared risk agreements.
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President reveals details of his price transparency proposal and the industry is questioning the changes. And in a special week-long series, we explore the changing dynamics of healthcare in North Carolina. Today you’ll hear from the state secretary of health about the move to Medicaid managed care.
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The Google whistleblower says there are many unanswered questions about how the company would handle patient data. The World Health Organization is working on a generic version of insulin to lower the cost. And a new California law restricting dialysis reimbursement rates is leaving patients in a lurch.
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The federal government is looking into Google’s project with Ascension Health. A teenager suffering from vaping related injuries gets a double lung transplant. And more patients went to the hospital last quarter – is it because they hit deductibles? Or a new trend.
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Google responds to reports about its access to millions of patient’s medical information. The federal government wants to crack down on a certain type of Medicaid payment. And the site-neutral payment rule is back in court.
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Google has access to detailed medical information as part of a partnership with a health system. It appears Walgreens is taking another step towards going private. We hear how a hospital system took steps to eliminate waste.
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The health industry lost an outstanding and visionary leader this weekend. Public health officials found a “very strong culprit” for what’s causing the mysterious vaping illnesses. And we hear from health system leaders who identified ways to eliminate waste in the US healthcare system.
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Portugal começou com um conde vindo do norte da Europa para ajudar a realizar a reconquista da Península, o qual casou com uma filha do rei de Leão e tomou conta do Condado Portucalense, tendo nascido deste casamento D. Afonso Henriques, que mais tarde decidiu desenvolver o condado para ser país independente, pelo que teve que se revoltar contra os partidários da dependência, naturalmente ligados a sua mãe.
Conseguiu a independência em 1140 e rapidamente expandiu a fronteira numa linha de perto de Barca de Alva até Lisboa, criando assim Portugal e depois alargando o território até abaixo do Tejo.
Quase um século depois o rei D. Afonso III, que antes vivia em Boulogne, e por isso foi cognominado "O Bolonhês", veio ocupar o trono, tendo reorganizado o Estado e iniciado a intensificação das ligações com o norte da Europa, o que permitiu a seu filho D. Dinis, que entretanto tinha recebido de seu avô D. Afonso X, rei de Leão e Castela, como presente o Algarve, continuar a organizar o País e iniciar o desenvolvimento da nossa Marinha. [...]
Fonte: DN
The government is taking a pharmaceutical company to court over patent infringement. Costco is adding prescription delivery as a benefit to certain members. And Medicare’s payment policies drove consolidation.
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A judge struck down another one of the Trump administration’s health care rules. Millennials are sicker than their Gen X predecessors and will face higher treatment costs. And another medical school offers free tuition to future primary care doctors with a stipulation.
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Seniors on Medicare are still paying a lot out of pocket. Drug store giant Walgreens Boots Alliance is exploring whether to go private. And another state is requiring more pricing transparency.
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A few more of President Trump’s healthcare policies are on hold. Georgia is the latest state to attempt a limited Medicaid expansion. And a shortage of a commonly used drug is causing treatment delays.
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A tech giant takes another step into the healthcare space. Haven Healthcare finally makes a public announcement. And a healthcare lobbyist explains how disruptors will likely run into some obstacles – in the form of state regulations.
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Bariatric surgery reduces waistlines but not wallets. The home state of Seema Verma is delaying one of her key policies. And one of the biggest healthcare companies will be getting into patients' homes.
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Sen. Bernie Sanders isn’t quite ready to say how he intends to fund his Medicare for All plan. The number of children losing health insurance continues to climb. Some American cities may soon have a big problem treating cancer, and bias in health care doesn’t just impact patients.
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Facebook might start reminding you to get a flu shot. Lawmakers passed more transparency bills – this time for drug prices. And Medicare revealed which hospitals were rewarded or penalized as part of the CMS' Hospital Value-based Purchasing Program.
This episode has been updated
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Walgreens is closing walk-in clinics across the country. Uber is partnering with an electronic medical record company as it increases its presence in the non-emergency ride business. A Pennsylvania hospital expands to the far east.
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New York’s process for settling surprise billing disputes actually raised prices for some types of care. A federal judge rules the government owes insurers for cutting a payment right before open enrollment in 2017. And we hear from an antitrust attorney about Sutter Health’s surprise settlement.
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A common algorithm for patient care has a racial bias. The president has reportedly chosen who he wants to lead the FDA. In addition to state and local governments, some hospitals are also suing opioid drugmakers.
This episode has been updated to accurately reflect the extent of vaping illnesses.
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The head of the CMS says the Trump Administration has a plan if the Affordable Care Act gets struck down...but she’s not sharing it. The Democrat's drug pricing bill gets out of an important committee. And a study finds profits go down as health systems get bigger.
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Health insurance premiums on the most common marketplace plans will be cheaper this enrollment cycle. A group of Republicans is out with a health care proposal – much of which we’ve seen before. And regulators are investigating state arrangements that help hospitals avoid federal antitrust scrutiny.
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Four of the defendants in the closely watched opioid litigation with two Ohio counties settled. Senator and Democratic presidential candidate Elizabeth Warren says her healthcare plan is coming. And soon a drone may be dropping off your prescriptions.
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The long-expected opioid trial in Ohio starts Monday. Another state is putting Medicaid work requirements on hold. And a healthcare attorney explains what the proposed Stark Law changes mean for physicians and health systems.
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UnitedHealthcare is trying to move more procedures out of the hospital. Walgreens announces a partnership with an insurer and pharmacy benefit manager. The Democrats honor the late Representative Elijah Cummings by naming the prescription drug pricing bill after him.
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A large California health system settles a closely watched antitrust case. A study details how much Democratic presidential candidates healthcare proposals would cost. And in Kansas, medical debt collections are "a government-sanctioned shakedown of the uninsured and underinsured."
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Democratic presidential candidates spar about how much will Medicare-for-all will cost and who will foot the bill. Amazon is establishing a center for excellence program for cancer care. There’s a shortage of a vital child cancer drug.
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More Medicare Advantage plans have five stars this year. House Speaker Nancy Pelosi’s drug pricing plan is estimated to save Medicare hundreds of billions. Will a course in hospital finance help rural hospitals keep the doors open?
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Medicaid work requirements are under scrutiny in the courts. A judge blocks a controversial immigration rule days before it takes effect. As Medicare open enrollment starts, Dr. Lisa Bielamowicz explains how CVS is making a big play in that market.
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Another hospital announced it will stop suing patients for unpaid medical bills. Hospitals in Colorado are not excited about the state’s public option plan. One doctor woke up to an early morning phone call this week with career-changing news - he won a Nobel Prize.
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Hoping to incentivize more value-based care, the Trump administration has unveiled a long-awaited reform to anti-kickback rules for physicians. A once prominent insurer CEO has been found guilty of driving while impaired in North Carolina. Bernie Sanders says despite recent health issues, he’s in no rush to release his medical records.
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Medicare open enrollment is around the corner and a key cost comparison tool isn’t working. A for-profit hospital company will forgive millions of dollars in medical debt. And another healthcare company appears to be planning to go public.
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According to a new study, a quarter of healthcare spending is wasteful. President Trump signed a proclamation mandating immigrants get health insurance. The healthcare sector led job growth in September.
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There’s been a lot of talk about price transparency for patients. But one doctor thinks it's just as important for doctors making treatment decisions to see prices. More on that in today’s episode of Gist Healthcare Daily.
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Walmart is going to start using quality metrics to steer employees to doctors. The president announced his wide-ranging Medicare executive order in Florida. Some doctors are asking for ethical guidance about the role of artificial intelligence in practice.
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President Trump is expected to detail his Medicare plans on Thursday in Florida. Another drug company settles an opioid case in Ohio. Drones, not people may be delivering medical packages to hospitals
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October brings new information on last year's healthcare programs. Accountable care organizations saved the government close to three-quarters of a billion dollars last year. More than 80 percent of hospitals are getting hit with readmissions penalties. Medicare Advantage plans are out just a few weeks ahead of open enrollment.
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Idaho wants to add work requirements to its Medicaid program. Some websites are advertising Trumpcare plans. Aledade CEO and co-founder Dr. Farzad Mostashari talks about the company's growth and why physicians are leaving hospital employment.
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It’s been almost a decade since the biggest reform of the American healthcare system in recent times - the Affordable Care Act. The law started to change how we pay for healthcare with the goal of increasing the value of patient outcomes. On this special episode of Gist Healthcare Daily, we talk to Dr. Farzad Mostashari about how the transition is going.
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You can now buy a bundle of groceries and health services at Sam’s Club. CEO of Blue Cross Blue Shield of North Carolina resigned after details of a drunk driving incident surfaced. The Senate votes to delay cuts to hospitals that treat a lot of Medicaid patients.
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A Memphis hospital wipes out medical debt for thousands of patients. Kaiser Permanente employees call off a strike after reaching a tentative deal. Employers are spending as much on healthcare as an economy car.
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Amazon launches a virtual clinic for employees. A merger between two Blue Cross insurers is on hold after a DUI arrest. Indiana residents are suing to block Medicaid work requirements.
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The new formula for disproportionate share payments was finalized Monday. Vermont Senator Bernie Sanders revealed his plan to forgive billions of dollars in medical debt. An antitrust expert breaks down some of the arguments in the Sutter Health antitrust case.
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Jury selection begins in an antitrust lawsuit against California-based Sutter Health. North Carolina’s Medicaid contracting process is being challenged. And for our special Weekly Gist feature, we have something on the nonhealthcare beat.
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House Speaker Nancy Pelosi revealed her plan to lower prescription drug prices. Another Democratic presidential candidate has another version on Medicare for all who want it. A plea for beer money leads to tens of thousands in donations to a children’s hospital. All that and more coming up on Gist Healthcare Daily.
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In a win for hospitals, it appears Congress will use a temporary funding measure to again delay cuts to a program that helps facilities who treat the sickest and poorest patients. Insurers and providers are pointing fingers about who’s to blame for rising healthcare costs. Bankers to go Walmart to check out the new health clinics.
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Tennessee is the first state seeking federal permission to change how it runs its Medicaid program. A federal judge says Medicare overreached when it reduced payment for off-campus clinics. Short-term health insurance plans are becoming more popular under the Trump Administration.
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Congress is investigating the private equity firms behind the anti-surprise billing ads. Purdue Pharma is trying to get all of the state attorneys general who sued to accept the settlement. A medication for peanut allergies gets FDA support.
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Purdue Pharma has filed for bankruptcy. And for the third time in almost two years, doctors are leaving a local hospital to join an independent practice in Charlotte, North Carolina. But to do this the physicians need to get out of their non competes.
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Thursday night’s Democratic primary debate showed divisions within the Medicare-for-all discussion. The government is challenging a court decision allowing a hospital to sell residency slots. Amazon’s online pharmacy company gets dealt a blow.
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Walmart is making a big move into healthcare, saying new clinics are the ‘crown jewel’ of the plans. Along with its new watch, Apple announced three new health research studies. The government has a warning for hospitals that still operate on fee-for-service.
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More people went to emergency departments in states that expanded Medicaid. About 20 percent more according to a new study. This is antithetical to the idea that with coverage you can do to the doctor instead of the hospital. But it isn’t quite that simple.
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One study finds administering certain medicines outside of the hospital could save insurance plans $4 billion a year. The Trump administration is considering a proposal that includes monitoring behavior of people with mental illness to predict violence. A Senate bill includes more funding for the National Institutes of Health.
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Optum is combining its data and care delivery businesses. The government is trying to a new approach to catch Medicare and Medicaid fraud before it happens. The infamous graphic showing the astronomical growth of administrators in healthcare is wrong.
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A federal judge approved a hospital sale of hundreds of residency spots. A contract dispute between an insurer and physician staffing company over reimbursement rates could impact 18 states. And people are turning to Groupon to afford CT scans and mammograms.
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Everyone agrees, hospital mergers have been happening more frequently. Whether it’s good for patients and reduces prices garners less consensus. The American Hospital Association is out with a study saying mergers reduce costs, but academics are critical of those findings.
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Presidential candidate Bernie Sanders wants to make billions of dollars of medical debt disappear for Americans. Walmart is bringing everyday low prices to medical care. Insurers aren’t happy about a new type of Medicare Advantage audit estimated to save as much as $1 billion.
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As the number of independent medical practices is shrinking, two companies in California are teaming up to try and help. Consolidation in the insurance industry continues with two Michigan insurers merging. With open enrollment six weeks away, Louisiana still hasn’t finalized Medicaid contracts because of an ongoing dispute.
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A favorite Bernie Sanders statistic about Americans going bankrupt because medical bills is not accurate. California lawmakers are targeting one hospital system with transparency legislation. And Medicare has been paying twice for some of the same drugs.
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In a new ad tied to his healthcare plan, Vice President Joe Biden, talks about his family's medical struggles. NBC reports the family who owns Purdue Pharma is offering a settlement to several opioid lawsuits. Medicare unveils a new online shopping tool ahead of open enrollment.
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An Oklahoma judge ruled Johnson & Johnson has to pay $572 million dollars for its part in fueling the opioid crisis. Doctors’ groups, including some backed by private equity firms, are pouring money into ads opposing surprise billing legislation. In addition to its public charge rule, the Trump administration sent states guidance about including a sponsor when considering an immigrant’s Medicaid eligibility.
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Introducing Gist Healthcare Daily - the weekday health policy and business news podcast from Gist Healthcare.
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