Industry News: Volume 3, Issue 17

AHA urges Department of Labor to ‘immediately’ investigate Multiplan

By Dave Muoio

fiercehealthcare.com – The American Hospital Association (AHA) is urgently calling for the Department of Labor to investigate MultiPlan and similar data companies that negotiate out-of-network service payments with payers. This plea stems from a revealing New York Times report detailing MultiPlan’s tactics, which prioritize driving down payments to providers for processing fees, often resulting in higher costs for patients and reduced reimbursements for healthcare providers. With insights from over 100 sources and documents, the report highlights regulatory gaps and the disproportionate burden on patients, employers, and providers. With significant financial stakes and healthcare quality at risk, the AHA’s call for investigation underscores the urgency of addressing these systemic issues.

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The U.S. has come up with its own global strategy to thwart the next pandemic

By Gabrielle Emanuel

npr.com – The Biden administration has unveiled a comprehensive Global Health Security Strategy aimed at bolstering U.S. preparedness against future pandemics and biological threats. This initiative expands health security partnerships to 50 countries, enhances coordination across government agencies, and seeks international commitments to pandemic preparedness. Despite praise for its intentions, experts raise concerns about gaps in vaccine research, funding, and addressing misinformation. As the U.S. navigates this strategy, the World Health Organization concurrently develops its own pandemic accord, emphasizing the urgency of global cooperation in pandemic prevention.

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CMS unveils person-centered primary care model but excludes high-revenue ACOs

By Noah Tong

fiercehealthcare.com – The Centers for Medicare & Medicaid Services (CMS) has launched the ACO Primary Care Flex Model, revolutionizing Medicare’s approach to proactive care. This initiative offers advanced shared savings payments and monthly prospective primary care payments to eligible ACOs. It aims to boost primary care funding and reduce health disparities. While praised for its potential to drive value-based care, excluding high-revenue ACOs has sparked debate. Industry leaders remain optimistic, anticipating improved outcomes and transformed care delivery.

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AAMC predicts significant physician shortage by 2036

By Pietje Kobus

healthcareinnovation.com – The Association of American Medical Colleges (AAMC) forecasts a significant physician shortage in the U.S. by 2036, ranging from 13,500 to 86,000 MDs. The report, “The Complexities of Physician Supply and Demand: Projections from 2021 to 2036,” underscores the importance of increased investment in graduate medical education (GME) to mitigate this shortfall. AAMC President David J. Skorton emphasizes the need for urgent funding to address future healthcare demands, particularly with population growth and aging driving up the demand for specialists.

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How virtual primary care can amplify value for providers and patients

By Bill Siwicki

healthcareitnews.com – Virtual primary care is emerging as a pivotal solution in modern healthcare, offering high-touch care coordination for preventive care, chronic condition management, and mental health services. In an interview with Kelly Bliss of Teladoc Health, revelations include the potential to reduce out-of-pocket expenses, avoid unnecessary care, and improve access to care while enhancing patient experiences. Virtual primary care addresses critical challenges in traditional care settings and shapes the future of healthcare delivery.

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American College of Surgeons endorses telehealth use in surgery

By Anuja Vaidya

mhealthintelligence.com – The American College of Surgeons (ACS) has endorsed telehealth use in surgery, citing its ability to enhance patient access, outcomes, and cost-effectiveness. With clear guidelines from the ACS Board of Governors Telehealth & Informatics Workgroup, surgeons can use telehealth for consultations, preoperative assessments, and postoperative follow-up. This statement addresses key concerns and barriers to adoption while highlighting research demonstrating telehealth’s impact on reducing no-show rates among surgical patients.

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Included Health launches virtual specialty care clinic with initial focus on cancer, weight loss and menopause

By Heather Landi

fiercehealthcare.com – Included Health is revolutionizing healthcare access with the launch of virtual-first specialty care clinics. Focused initially on cancer, women’s health, and metabolic health, these clinics promise rapid access to over 4,000 specialist physicians. By bridging gaps in specialty care, Included Health aims to provide seamless, personalized healthcare experiences for its members. With rising wait times and costs for specialty care, this initiative addresses critical needs while leveraging technology and clinical expertise.

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