Digital as the Differentiator for Biopharma and Medtech

Digital as the Differentiator for Biopharma and Medtech

With the Inflation Reduction Act now on the books, the U.S. Centers for Medicare & Medicaid Services (CMS) will begin negotiating drug prices with the pharmaceutical industry. That, combined with other headwinds such as increased competition from me-too drugs, and ever-present pricing pressure from payers, means that pharma players now more than ever need a new and powerful tool to differentiate their products. We believe the next decade of transformation is digital.
Learning from the auto industry Almost every industry has had to confront a fundamental existential question: What is our product? Consider the automotive industry, which once was largely about hardware…

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HHS Aims To Reduce Prescription Drug Costs Through 3 New Models

HHS Aims To Reduce Prescription Drug Costs Through 3 New Models

The U.S. Department of Health & Human Services (HHS) unveiled three new models Tuesday that will be tested by the CMS Innovation Center and aim to lower prescription drug costs. The models include access to $2 generic drugs.
The news is in response to President Joe Biden’s executive order issued in October, which directed HHS to find ways to lower prescription drug costs and improve access to drug therapies for those enrolled in Medicare and Medicaid health plans. The models are meant to build on the Inflation Reduction Act of 2022, which includes allowing Medicare to negotiate lower prescription drug prices for…

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KLAS: What Impact Do Automated Prior Authorization Solutions Provide?

KLAS: What Impact Do Automated Prior Authorization Solutions Provide?

What You Should Know:– Prior authorization is mandated by payers to ensure that certain clinical procedures and medications being ordered are necessary. To alleviate the heavy administrative burden this requirement causes, healthcare organizations have adopted automated prior authorization solutions.– For this report, KLAS interviewed 30 respondents from 26 unique organizations to understand their experiences using these solutions and what outcomes they have seen.Understanding the Impact Automated Prior Authorization Solutions ProvideThis report is a perception study designed to help readers understand where the automated prior authorization market is and what outcomes organizations using automated prior authorization are seeing. To gather these perspectives, KLAS…

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Memorial Healthcare System grows its telehealth offering to 61 programs

Memorial Healthcare System grows its telehealth offering to 61 programs

Before the widespread adoption of telemedicine technology, there were several problems that hindered the delivery of healthcare services for most healthcare organizations.THE PROBLEM
One of the main problems was access to healthcare, particularly with working families and those with chronic conditions. Many people lacked convenient access to medical care and providers, making it difficult for them to receive the care they needed.
Another problem was the cost of healthcare, which could be prohibitively expensive for many people. This was especially true for those without insurance or with limited coverage. Additionally, long wait times for appointments and limited availability of specialists further exacerbated the…

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Virtual care enables BrightView Health to increase outpatient access

Virtual care enables BrightView Health to increase outpatient access

BrightView Health, a behavioral health facility that specializes in addiction treatment and substance abuse, already was using telehealth when the COVID-19 pandemic and associated response happened. The organization mostly was using telehealth between its various locations.THE PROBLEM
However, BrightView did not have a secure communications platform to engage with patients either synchronously or asynchronously.
“So, the pandemic and the lockdowns created some potential gaps in access to care that we needed to predict and fill,” said Navdeep S. Kang, chief clinical officer at BrightView Health and a fellow with the Obama Foundation. “We looked at several platforms to implement secure communications.
“We were specifically interested…

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Intermountain and Story Health partner on specialty care for heart failure

Intermountain and Story Health partner on specialty care for heart failure

Intermountain Health is looking to artificial intelligence and high-touch coaching to increase care personalization and medication adherence for patients with heart failure.WHY IT MATTERS 
Coaches from Story Health, which helps develop personalized care plans using clinical data, will be available to answer Intermountain patients’ questions via text or call. They’ll also remind them about essential medication changes and ensure that vascular patients have access to the medications they need between visits.
“Patients have long journeys with their health, and a significant part of that journey takes place after they leave the clinician’s office,” said Tom Stanis, CEO and cofounder of Story Health, in…

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Johns Hopkins AI models predict ICU delirium risk

Johns Hopkins AI models predict ICU delirium risk

Two dynamic analytics models developed at Johns Hopkins University predicted delirium-prone patients when tested on two datasets drawn from 100,000 stays at a Boston hospital’s intensive care unit, according to new research.WHY IT MATTERS
Delirium – sudden bouts of confusion, inattention, paranoia, agitation and hallucinations – can put patients at higher risk of prolonged hospitalization, future dementia and death. By forecasting delirium, alerted clinicians could apply countermeasures that can mitigate adverse outcomes, according to the premise of artificial intelligence research published in Anesthesiology. 
“For a lot of these physiological transitions, we think that there are early warning signs that may not be obvious…

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Remote therapeutic monitoring is reimbursable – here's what you need to know

Remote therapeutic monitoring is reimbursable – here’s what you need to know

Ever since CMS released the new CPT codes for remote therapeutic monitoring last year, health systems have been eager to use them, but unsure of the criteria. Providers are acknowledged for the time they spend connecting with patients outside of the office.With the new CPT codes, providers can get reimbursed for:

Educating patients on how to use a remote care-management platform.

Monitoring a platform’s alerts and patients’ use of remote education.

Direct patient/provider messaging within the platform.

Data collection via the platform, i.e., collecting patient feedback on pain levels, activity and motion.

To qualify for reimbursable RTM, providers need to use software deemed a medical device…

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Third-party data breach round-up: mscripts, Diligent, Mailchimp

Third-party data breach round-up: mscripts, Diligent, Mailchimp

This month, more than 114,000 individuals may have experienced personally identifiable information and protected health information exposures from these incidents, while an email marketing hack is a new source for phishing attacks.Medication adherence platform mscripts breached
On January 17, mscripts, a cloud-based mobile pharmacy platform that focuses on patient engagement and medication adherence solutions, reported to the U.S. Department of Health and Human Services unauthorized access/disclosure that involved protected health information of 66,372 individuals, according to the Office for Civil Rights cases under investigation list.
The San Francisco-based platform, owned by Dublin, Ohio-based Cardinal Health, uses interactive SMS messaging and branded mobile apps to…

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Omaha program uses HIE tech to improve postpartum care for minority parents and children

Omaha program uses HIE tech to improve postpartum care for minority parents and children

CyncHealth, Collective Medical and Innsena are being recognized by the Department of Health and Human Services’ Racial Equity in Postpartum Care Challenge, including federal funding of $40,000, for their postpartum care program in Omaha.Pregnancy-related deaths are three to four times more common among minorities than among Caucasian women, even among those with a college degree. This program improves postpartum care for Black and Indigenous parents and children with high-risk conditions who participate in Medicaid and the Children’s Health Insurance Program, and significantly reduces maternal and neonatal mortality.
Out of the 25 winners recognized by HHS, this program is the only one using health…

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