Friday, December 2

Health

Health

Dr. Akram Boutros talks about MetroHealth ouster

Dr. Akram Boutros, who was ousted Monday night, Nov. 21, as CEO of MetroHealth due to what the system characterizes as abuses related to bonus pay, maintains he has done "nothing wrong here" and is, instead, a victim of retaliation for blowing the whistle on board of trustees practices related to the hiring of his successor. "I absolutely believe I will be vindicated," Boutros said during an interview at Crain's offices on Tuesday afternoon, Nov. 22. He added, "I have absolutely nothing to hide." Boutros, accompanied by his attorney, Jason R. Bristol of Cohen Rosenthal & Kramer LLP, said he was "completely blindsided" by the allegations about bonuses when those allegations were presented to him in October. He also described, in detail, why he sees the bonus payments as having been ...
America, the intolerant – The Health Care Blog
Health

America, the intolerant – The Health Care Blog

BY ANISH KOKA Historically, the great tension between liberty and authority was between government as embodied by the ruling class and its subjects.  Marauding barbarians and warring city-states meant that society endowed a particular class within society with great powers to protect the weaker members of society.  It was quickly recognized that the ruling class could use these powers for its own benefit on the very people it was meant to protect, and so society moved to preserve individual liberties first by recognizing certain rights that rulers dare not breach lest they risk rebellion.  The natural next step was the establishment of a body of some sort that was meant to represent the interests of the ruled, which rulers sought agreement and counsel from, and became the precur...
A golden moment for telehealth depends on meeting the need  for broadband
Health

A golden moment for telehealth depends on meeting the need  for broadband

Imagine y­­­­­ou had $14 billion, but you couldn't give it away. The Federal Communication Commission has a similar problem with a key broadband grant program – but telehealth might help save the day. For better or worse, the internet is embedded into everything humans do, from educating our young to practicing medicine. Delivering telehealth is difficult without the internet. However, nearly 28 million U.S. households still lack internet access. The FCC established the Affordable Connectivity Program in December 2021 to provide access and subsidized computing devices. It's free to enroll in ACP, but many people are reluctant. Telehealth can win over fence-sitters. The universal need for healthcare can make ACP coupled with telehealth a win-win for everyone. Just about everybody gets si...
UnitedHealth-Change Healthcare merger: DOJ, states appeal
Health

UnitedHealth-Change Healthcare merger: DOJ, states appeal

The Justice Department and two states appealed a federal judge's decision to toss a challenge to UnitedHealth Group's $13 billion merger with technology company Change Healthcare, according to a court notice filed Friday. The federal government, New York and Minnesota did not specify why they were appealing Judge Carl Nichols' ruling, which he handed down in the U.S. District Court for the District of Columbia in September. The Justice Department sued to block the deal in February, alleging it would violate federal antitrust law by giving insurer UnitedHealthcare access to intelligence on how rival health insurance companies structure their provider networks. The plaintiffs waited until the final possible day to appeal Nichols' decision. The Justice Department now faces the challenge o...
TeamHealth Louisiana billing lawsuit dismissed
Health

TeamHealth Louisiana billing lawsuit dismissed

A federal judge dismissed the lawsuit filed by the Louisiana Municipal Risk Management Agency against TeamHealth on Friday, ruling that the plaintiff does not have standing to sue. Judge Clifton Corker handed down the decision in the U.S. District Court for the Eastern District of Tennessee, writing that the plaintiff could not advance the lawsuit because the reimbursements in question came from government entities, not the Louisiana Municipal Risk Management Agency, which administers benefits for local government employees in the Pelican State. The Louisiana Municipal Risk Management Agency sued TeamHealth in March, alleging the Knoxville, Tennessee-based provider group violated federal law by inappropriately billing for “tens, if not thousands, of hundreds of thousands of claims” and...
Health

Rural hospitals are closing, and Congress needs to step in

Keokuk, Iowa; Crisfield, Maryland; Jellico, Tennessee; Bowie, Texas. They’re four very different areas of our country that all represent a dangerous trend: Each has seen their local hospital close since the start of 2020, and they’re not alone. Since the beginning; of the COVID-19 pandemic, as many as 25 rural community hospitals have shuttered, dropped in-patient care or severely cut services.  Congress kept that number from being much higher, saving many hospitals from closure by providing crucial support during the peak the pandemic that kept care accessible to millions of patients in rural areas. While the height of the pandemic is behind us, the needs of these small community hospitals remain. It is vital for lawmakers to step up again, this time to stop nearly $2 billion in cu...
The AMA v. Dobbs. Part 1. – The Health Care Blog
Health

The AMA v. Dobbs. Part 1. – The Health Care Blog

BY MIKE MAGEE Should anyone present know of any reason that this couple should not be joined in holy matrimony, speak now or forever hold your peace.”     Book of Common Prayer, Church of England, 1549 Last evening Trump rose from the ashes and declared it was time to “Make America Great and Glorious Again” (MAGAGA). This past week, five days after the Midterm elections, AMA President, Jack Resnick, Jr., MD, raised his voice from the podium at the AMA Interim Meeting in Hawaii with the AMA’s own version of a call to action: “But make no mistake, when politicians insert themselves in our exam rooms to interfere with the patient-physician relationship, when they politicize deeply personal health decisions, or criminalize evidence-based care, we will not back down…I never ...
Centene to sell Magellan Specialty Health to Evolent Health
Health

Centene to sell Magellan Specialty Health to Evolent Health

Centene announced plans Thursday to sell its Magellan Specialty Health for more than $600 million in cash and stock to administrator Evolent Health.  The sale is part of Centene’s ongoing efforts to jettison  its non-health plan businesses. Evolent will pay at least $400 million in cash and about $200 million in stock for the specialty management service, according to Centene. Depending on Magellan Specialty Health’s performance in 2023, Centene could receive another $150 million in cash and Evolent common stock in 2024. The insurer did not disclose how that performance would be measured.  Centene expects the transaction to close in the first half of 2023, and plans to use the sale proceeds to repurchase stock and reduce debt. Federal antitrust regulators must approve the deal. Centene...
Is Care Navigation Healthcare’s Next ‘Gold Mine’? Quantum Health’s Move to Win Over Larger Employers – The Health Care Blog
Health

Is Care Navigation Healthcare’s Next ‘Gold Mine’? Quantum Health’s Move to Win Over Larger Employers – The Health Care Blog

BY JESSICA DaMASSA, WTF HEALTH One-to-watch as a potential health tech IPO this year is care navigator Quantum Health, and I’m talking to CEO Zane Burke about both their breaking new product launch AND the key differences between Quantum and the increasingly competitive field of other employer benefits advocacy-based businesses like Accolade, Rightway, and Transcarent. Private equity backed, two-decades old, and EBITA positive, Zane says Quantum Health is delivering an ROI of “over two-and-a-half to one” to its client roster of 450 top large, self-insured employers and saving more than 14% on all healthcare costs over time. The new product – Quantum Health Access – is a streamlined, more flexible version of the soup-to-nuts Complete Care offering capable of yielding these resul...
Our Plants Should Be Plants – The Health Care Blog
Health

Our Plants Should Be Plants – The Health Care Blog

BY KIM BELLARD It seems like most of my healthcare Twitter buddies are enjoying themselves at HLTH2022, so I don’t suppose it much matters what I write about, because they’ll all be too busy to read it anyway.  That’s too bad, because I was sparked by an article on one of my favorite topics: synthetic biology.   Elliot Hershberg, a Ph.D. geneticist who describes his mission as “to accelerate the Century of Biology,” has a great article on his Substack: Atoms are local.  The key insight for me was his point that, while we’ve been recognizing the power of biology, we’ve been going about it the wrong way.  Instead of the industrialization of biology, he thinks, we should be seeking the biologization of industry. His point: Many people default to a mindset of industrializat...