Navigating the healthcare economy | Healthcare Finance News

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COVID-19 revealed our national weaknesses in healthcare – an interconnected reliance on the supply chain, for one. It also showed our individual strengths and resilience. With regulations lifted, providers learned just how quickly they could adapt during surges and treat non-COVID-19 patients virtually. Health equity awareness, staffing burnout and shortages, and mental and behavioral healthcare became issues as never before.

Value-based contracts became more desirable after the pandemic showed the weakness of relying on fee-for-service. What’s followed are more partnerships, investments in AI and machine learning, and the acceleration of the adoption of digital health to attract and retain patients.

While national leaders discuss drug pricing and care models, providers will determine their future in investment decisions.

See our coverage below of these innovations and investment decisions, which we will update throughout the month of October. – Susan Morse, managing editor

The rise of hospital at home

Mark Larson, principal of Sg2, a consulting and analytics subsidiary of Vizient

The benefits, both economically and for the patient, have worked so well that hospitals are pursuing the model beyond the pandemic.

Kaiser, Mayo, Medically Home found coalition to promote advanced hospital-at-home services

Person with IV in arm using smartphone

Federal regulators should “put guardrails on, but let us continue the good work,” says Mayo Clinic’s Dr. Michael Maniaci.

‘You can’t navigate your way through a broken system’: Transcarent’s Glen Tullman on healthcare cost, quality

Transcarent's Glen Tullman

At the beginning of October, Transcarent inked a deal with Walmart to lower prescription drugs.

Northwell Direct leads and rides the trend of direct contracting in the self-insured market

Northwell Health office

CEO Nick Stefanizzi says what’s different, even from Haven, is that there are providers in these organizations.

Moving past inertia will allow innovation to increase the value of employer-sponsored care

The HLTH panel on the value of employer-sponsored care

Industry innovators are working to align incentives across the system and reduce the inefficiencies that have plagued healthcare for decades.

Investment in digital health requires prioritizing capital allocation

Group of businesspeople looking at a laptop

Strategies include the “payvider” trend as payers build bigger provider platforms surrounded by digital enablement.

‘Omnichannel’ is the new watchword as big tech, retail get serious about healthcare

Business Insider reporter Blake Dodge moderates a session with Dr. Sree Chaguturu, chief medical officer at CVS/Caremark, and Marcus Osbourne, SVP at Walmart Health

At a recent gathering in Boston, leaders from Walmart, CVS, Verily and Uber Health discussed how their organizations’ skills help them “meet consumers where they are.”

ROI realized from pre-bill review of documentation and coding

healthcare worker using computer

Hospitals can decrease denials by having physicians involved in the mid-revenue cycle review process.

Citadel Health awarded £15.9M contract to modernise Welsh national pathology services

Welsh parliament sign

The Australian firm will provide its laboratory information management system.

How analytics can help providers capture money they’re leaving on the table

Heather Lavoie, president and CEO of Geneia

A population health expert also shows how technology can monitor patient leakage and improve engagement to drive patient retention.

‘Medicare Advantage-in-a box’ by nirvanaHealth is on Amazon Web Services

Worker pointing at laptop screen while other worker looks

By deploying automation with built-in compliance, payers offering MA plans can rely on a “digital workforce.”

Doctor on Demand, Grand Rounds Health rebrand as Included Health

Patient using blood pressure cuff during telehealth appointment

The new brand promotes itself as being more inclusive, and part of the focus will be on expanding virtual and behavioral health services.

Digital pharmacies on the rise. But who is going to pay?

Person getting prescription

Today at HLTH, panelists discussed how digital is changing the medication delivery space and who will pay for the services.

Contributed: Why B2C2B will be the future go-to-market strategy for virtual care

Person on smartphone gesturing toward neck

Propeller vet Chris Hogg writes on the go-to-market strategies for digital health companies.

Retail giant Best Buy snaps up remote monitoring company Current Health

Couple sitting at a table, one attending telehealth appointment on phone

The acquisition builds on Best Buy’s previous investments in senior care and remote patient monitoring.

Medicare Advantage startup Devoted Health rakes in $1.15 billion in Series D funding

Person using tablet

The Series D raise brings Devoted Health’s total funding pot to $1.99 billion.

Workforce wellbeing company Virgin Pulse snaps up engagement tool Welltok

Vigin pluse to acquire Welltok graphic

The acquisition will open up new markets to Virgin Pulse, including health systems.

Blue Shield of California teams with Google Cloud for billing, payment AI

Google Cloud logo sign

The companies say they will use artificial intelligence and machine learning to digitize healthcare claims and improve the accuracy and timeliness of the process.

Walmart and Transcarent partner to lower costs in the self-insured market 

Transcarent CEO Glen Tullman

The agreement allows Transcarent, which offers a digital platform “overlay” to existing plans, to share Walmart prices on drugs.

How COVID-19 drove the need to make physicians’ lives easier

How COVID-19 drove the need to make physicians' lives easier

MedAware’s AI solution reduces EHR noise by cutting down on the excessive number of medication alerts.

Anthem, Providence tap Vim for value-based care platform deployment

Healthcare worker using a tablet

The goal is that the technology platform will enable higher quality care and better patient experiences at a lower cost.

COVID-19 may have unexpected benefit of freeing up funds for rural hospitals to invest in technology

Healthcare worker using a computer

Rural providers need to upgrade “off-brand” EHRs that are no longer supported and do not connect to other systems.

Cerner intros new RevElate patient accounting tool

Cerner office building

The aim of the new revenue cycle management technology is to offer health systems more flexibility to integrate data from different sources, such as new provider acquisitions that use different IT systems.

Healthcare innovation, digital health rake in big investment dollars in Q3

Stethoscope on paper showing bar graph

In the third quarter of 2021 alone, digital health companies scored $6.7 billion across 169 deals.

Employers anticipate health costs rising 5% in 2022

Healthcare workers walking in hospital hallway

The CEO of the SSI Group shares some perspective on predictive models and forecasting tools, an increased demand for patient education and fine-tuned approaches to a remote workforce.

IT strategies for rebuilding a pandemic-ravaged revenue cycle

Diana Allen, CEO of the SSI Group

The CEO of the SSI Group shares some perspective on predictive models and forecasting tools, an increased demand for patient education and fine-tuned approaches to a remote workforce.

Healthcare implications of reconciliation package loom large

President Biden giving speech

President Biden’s sprawling economic agenda is at stake in the division between moderates and progressives in his party.

Tech-driven clinical trial startup TrialSpark lands $156M in Series C

Doctor pointing at computer screen in front of colleagues

This new round of funding brings the company’s total raise to $250 million.

Henry Ford Health System taps Contessa for at-home hospital care

Henry Ford Health System buldings

The pandemic spurred hospital at home programs but the benefits for providers and patients means their continuation.

Providers struggle to meet rising consumer demand for digital healthcare

Person looking at calendar on tablet and smartphone

There’s plenty of opportunity in the area of real-time appointment availability, which is highly desired by consumers, the report says.

The benefits of using genomic data for health systems and patients

Lab worker pointing to table screen held by other worker

Widespread use requires greater reimbursement and an enterprise-wide strategy.

HIMSSCast: Telehealth and value-based care

UPMC's Dr. Andrew Watson

UPMC’s Dr. Andrew Watson joins HIMSSCast to discuss two major trends in healthcare and how they intersect.

Mayo Clinic and Kaiser Permanente invest in at-home acute level care

Person attending telehealth appointment on a tablet

Regulations allowing nonhospital space to be used for patient care during the COVID-19 emergency gave rise to hospital care in the home setting.

How algorithms developed during COVID-19 are expanding the digital strategy at UMass Memorial

Dr. David McManus (left), chair of the Department of Medicine and Dr. Michael Gustafson, president, UMass Memorial Health

The soon-to-launch Hospital at Home uses predictive analytics to determine who can safely go home to remote, acute care.

Executives have yet to fully commit to digital, consumer-centric care, Kaufman Hall finds

Doctor showing medical images to patients

Hospitals need to focus on digital investment to compete with other hospitals and retail and technology companies.

Employees increasingly see mental health benefits as essential, but their bosses lag behind

Worker at a computer rubbing eyes

A commissioned survey from Modern Health and Forrester Research shows a disconnect in perceptions of offerings.

Telehealth has grown by leaps at doc practices, with wide variance in usage patterns

Person attending telehealth appointment

More than 70% of physicians surveyed for the new AMA Physician Practice Benchmark Survey work in practices that use video conferencing, with virtual care especially popular among specialists such as dermatologists and urologists.

HIMSSCast: Untangling the complex web of US drug pricing

Capital Rx CEO A.J. Loiacono

Capital Rx CEO A.J. Loiacono tells us why drug prices are so complex and opaque, and what can be done about them.

How to create the hospital of the future based on lessons of the past

Northwell Health CEO Michael Dowling

Northwell Health CEO Michael Dowling looks at how health systems and hospitals will change because of the pandemic.