Fierce Healthcare hosted the second annual Fierce Health Payer Summit in November. Top leaders and decision-makers in the healthcare and payer industry convened in Austin, Texas, for two days of discussions.  

During the event, Fierce’s Emma Beavins interviewed several panelists on the show floor about what they think the ideal payer of the future looks like. In this episode, you’ll hear about improving the member experience, reforming prior authorization and leveraging AI. 

The speakers featured in this episode are:  

• Alex Azar, former Health & Human Services secretary

• Tanvi Patel, general manager and director of Amazon Pharmacy

• Michael Anne Kyle, associate professor of health policy at the University of Pennsylvania

• Ed DeVaney, president of employer & health plans at CVS Caremark

• Brian Kim, CEO of HighRoads 

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Heather Cox, president of insights and empowerment at Zelis, discussed the challenges of achieving interoperability in healthcare during a recent podcast. She highlighted technical issues, diverse stakeholder needs and data silos as key obstacles. Cox emphasized the importance of real-time, secure data for payer-member engagement and suggested APIs as a promising solution. She also advised health plans on choosing technology partners and advocated for a data-centric approach to improve patient care. Listen to the podcast to learn more.

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More than one million women reach menopause each year in the U.S. Menopause can bring on many unwanted symptoms and increase the risk of chronic conditions, affecting a woman’s health and quality of life. Yet many report feeling uncomfortable talking about this challenging transition in the workplace and with their healthcare providers. Many also struggle to find relief for their symptoms. Experts say employers and providers should be doing more to care for women in midlife.  

To close out October, Menopause Awareness Month, Fierce Healthcare’s Anastassia Gliadkovskaya sat down with Kathleen Green, M.D., an OBGYN at Maven Clinic. Like many other physicians, Green did not get formal training on menopause in medical school. She had to learn how to help women through this natural part of aging. In the episode, they discuss why the status quo is not working and what it will take to improve the system.  

To learn more about the topics in this episode:  

• HLTH24 Day 2: Halle Berry wants to change the dialogue on menopause
• HLTH24: Jill Biden announces $110M ARPA-H funding award, prods industry to invest in women's health
• Menopause care is still a largely untapped market. Here's why investors and startups should dive in
• Industry Voices—Menopause is making headlines. Are healthcare workers keeping up?

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In healthcare, the best solutions come from bringing different perspectives to the table. 

That’s the core idea behind Inlightened, a platform connecting innovators with a network of vetted experts, including clinicians, industry leaders, policymakers and more. 

In this week's episode of "Podnosis," Fierce Healthcare’s Emma Beavins chats with Inlightened CEO Shelli Pavone. She explains why diverse viewpoints are essential for tackling the industry’s toughest challenges and how building real engagement is the bedrock for innovation that fills gaps in the industry and can endure.

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In the last 30 years, HIV rates have gone down, in large part because of the game-changing prescription drug pre-exposure prophylaxis (PrEP), which reduces the risk of contracting HIV through sex by 99%. Since the FDA approved the drug in 2012, more people have started to use it, and HIV rates have steadily decreased. However, not everyone sees the same results.

The South had 53% of new HIV diagnoses in 2022 but represented only 39% of PrEP users in 2023. Regionally, Black people made up 48% of new HIV diagnoses in 2022, but only 22% of PrEP users in 2023.  

In a recent collaboration between Fierce Healthcare and new investigative LGBTQ-focused news outlet Uncloseted Media, Anastassia Gliadkovskaya and Sam Donndelinger dive into the HIV epidemic and how it disproportionately affects at-risk individuals in the South. Barriers like a lack of awareness, insurance coverage, and stigma contribute to inequitable access. 

Read the full story at FierceHealthcare.com or UnclosetedMedia.com. 

In this week’s episode of “Podnosis,” Gliadkovskaya and Donndelinger discuss the reporting process and introduce three patients impacted by the HIV epidemic who share their personal experiences.

To learn more about the topics in this episode: 

• 'I'm another statistic. I feel let down': How HIV prevention stays out of reach for many

• CMS proposes risk adjustment changes, broker fraud crackdown for 2026 plan year

• ‘A mixed bag’: Fifth Circuit rules on ACA preventive services legal case

• Blue Cross NC removes HIV drugs from costly price tiers 

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There are many complexities and challenges that can lead to inefficiencies and friction among payers, providers, and healthcare consumers in the payments landscape.

In this podcast episode, we sit down with Dylan Papa and Michael Bernabe to discuss fresh perspectives for healthcare payers on how to improve claims payments operations, meet digital demands, and enhance the healthcare payments experience for all.

Zelis built Zelis Advanced Payments Platform to cleverly address these challenges by managing all payments and communications in one intelligent hub, unlocking efficiencies, ensuring compliance, and delivering the modern and customized payments experience that providers need and members demand – now, and in the future.

In this interview, Papa and Bernabe discuss the significance of combining the fusion of centralizing all payment modalities, plus communications and additional advice to payers on how to effectively modernize for the future.

To find out more, tune in to the full episode or visit Zelis.com.

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Chronic kidney disease is a silent threat. It is one of the leading causes of death in the U.S., yet 90% of those affected are unaware they have it. The lack of widespread testing means many, particularly in the Black community, face rapid health deterioration, often landing in dialysis without warning.

In this episode, Geoff Martin, CEO of Healthy.io, joins Fierce Healthcare’s Emma Beavins to explore how his company is tackling this hidden crisis and changing the future of chronic kidney disease care. 

To learn more about the topics in this episode: 

• Healthy.io, National Kidney Foundation team up to promote early disease detection, using tech to reach at-risk people
• More than half of Americans are unfamiliar with chronic kidney disease, survey finds
• 'Podnosis': Changing the game on kidney care
• Humana finds value-based care leads to fewer hospital admissions for kidney patients

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With just a month left until the Nov. 5 presidential election, Fierce Healthcare's Heather Landi spoke with David Shulkin, M.D., to gain his insights on the future of healthcare policy.

Shulkin, a healthcare executive, served as the ninth Secretary of Veterans Affairs under the Trump administration. Notably, he was the only cabinet member retained from the Obama administration, after serving 18 months as the VA’s Under Secretary for Health.

In their conversation, Shulkin also reflected on his time as VA Secretary, including his decision to award Cerner a $10 billion, no-bid contract to replace the VA’s outdated medical records system.

To learn more about the topics in this episode: 

• VA extends EHR modernization contract with Oracle Health for 11 months
• VA pauses $16B Oracle Cerner EHR deployments indefinitely to address error-ridden early rollout
• Former VA secretary's latest venture, Override, emerges out of stealth to tackle chronic pain

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Certain cancer rates are on the rise, and outcome inequities remain a major public health concern. Getting into clinical trials is difficult, care is fragmented and treatments can be prohibitively expensive. Meanwhile, research for many cancers is underfunded. 

The American Cancer Society is on a mission to end cancer as we know it. Its venture capital and impact investment arm, BrightEdge, invests in early-stage companies developing therapeutics, diagnostics, devices and technologies that share in this goal. 

In this week’s episode of “Podnosis,” Fierce Healthcare’s Anastassia Gliadkovskaya chats with BrightEdge’s managing director Alice Pomponio about how the organization leans into its expertise in research, patient support and advocacy when working with entrepreneurs, what it looks for in emerging companies and how it measures their impact. 

To learn more about the topics in this episode: 

• What will it take to improve the future of cancer care? Clinicians, patients stress better collaboration and reimbursement
• American Cancer Society, Color Health team up to boost cancer screenings for employees
• American Cancer Society, ASCO join forces to create 'credible' online cancer information under one roof

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Employers hold significant power in the healthcare industry. About 60% of people under the age of 65 received insurance coverage through their employer last year, according to KFF. 

Kim Thiboldeaux stepped into the role of CEO at the Northeast Business Group on Health in early 2024. The organization's members provide coverage for millions of lives.

In this week's episode of "Podnosis," Thiboldeaux sits down with Fierce Healthcare Senior Writer Paige Minemyer to discuss her goals at the helm of NEBGH and the healthcare topics employers are watching most closely. 

To learn more about the topics in this episode: 

• NEBGH: Here's how employers can support cancer patients in the workplace
• Employers seek guidance on mental health benefits: survey
• New NEBGH guide aims to help employers tackle social determinants of health
• Emergency preparedness lessons for employers from COVID-19

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Healthcare worker burnout is a critical issue. Bill Charnetski, EVP of Health System Solutions at PointClickCare, reveals how burnout impacts both patient care and operational efficiency, sharing personal insights from his wife’s experience in skilled nursing administration. He advocates for leveraging health information technology to reduce administrative burdens, enhance job satisfaction, and minimize manual errors. The importance of thoughtful policy-making in supporting healthcare workers and ensuring technology adoption effectively addresses their needs without adding to their workload cannot be underscored enough. A shift in tone towards valuing frontline healthcare heroes and implementing flexible, targeted regulations to improve care and operational outcomes is needed.

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Healthcare providers of all sizes are feeling the impact of burnout, time constraints, and burdensome administrative requirements. This is especially challenging for private practices, which often experience resource and time constraints. Managing these challenges can be overwhelming. 

How are practice management companies meeting the evolving needs of healthcare providers? 

Practice Better is an electronic health record and practice management software that serves independent health and wellness practitioners. In this week’s episode of “Podnosis,” CEO Kim Walsh shares how the company prioritizes value and the different approaches it takes to best serve its customer base. 

To learn more about the topics in this episode: 

• Practice Better adds new tools, billing integration for mental health practitioners
• Elation Health rolls out AI scribing tool embedded in its EHR for primary care docs
• SimplePractice expands into psychiatry with prescription management tool
• 2024 Outlook: How tech, incentives could push measurement-based care in behavioral health

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Our early experiences as kids have a lasting impact on our health and wellbeing. From facing adverse childhood experiences to various social needs, kids are especially vulnerable to their environment, as their brains are still developing.

Schools play a crucial role in helping to support kids. However, our education system today does not do enough to equip children to understand their mental wellbeing and emotions. So argues Jessica Gomez, Psy.D., a bilingual psychologist in Texas. Gomez is executive director of Momentous Institute, a nonprofit offering mental health services and operating an elementary school in Dallas. 

In this week's episode of "Podnosis," Gomez walks Fierce Healthcare's Anastassia Gliadkovskaya through the importance of integrating social-emotional learning into education and how doing so early on can have lifelong benefits.  

To learn more about the topics in this episode: 

• California is funding managed care plans to bring mental healthcare to schools. Here's how it's going
• Experts weigh in on how to tackle growing teen mental health crisis
• Evernorth: How employers can take the lead on addressing youth mental health
• Cigna taps first 22 awardees in grant program targeted for youth mental health

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Specialty drugs bring new hope to patients with complex conditions, but they also present unique challenges.

In this episode of Podnosis, Heath Clendening speaks with Peter Demogenes, Senior Vice President of Product at Optum, about how health plans are adapting to the rapidly changing specialty care sector.

Demogenes explains two common strategies health plans use.

First, individualized management typically sees issues managed on a case-by-case basis, focusing on medical benefits, and utilizing tools to manage costs independently.

Second, holistic management takes a broader view, recognizing the interconnectedness of patients, providers, payers, and stakeholders.

The conversation also highlights the role of innovation, featuring Optum’s Specialty Fusion program. Designed to simplify care for patients with complex conditions, this program not only lowers the cost of expensive specialty drugs but also streamlines treatment decision-making for health plans, helping patients start their therapies sooner.

For further insights into how these innovations are shaping the future of specialty care, listen to the full episode.

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Microplastics are everywhere, including our bodies. Research suggests that ingested microplastics can reduce fertility and increase the risk of cancer and other diseases. However, the full effects of their chemical makeup on human health are not yet known.

Plastic has been used in the healthcare setting since the 1900s. The material does have some benefits, like hygiene and lower cost. At the same time, single-use plastics contribute enormously to healthcare waste and pollute the environment, in addition to the body. 

In this week's episode of "Podnosis," two experts break down the history of plastics use in the healthcare sector and what it would take for an organization to phase them out. 

To learn more about the topics in this episode: 

• Breathing better: Hospitals begin to phase out major pollutants in patient care
• Industry Voices—Collective action is the key to decarbonizing healthcare
• Hackensack Meridian hospitals first to attain Joint Commission's new sustainability certification
• Most clinicians believe hospitals should address climate change, Commonwealth Fund survey finds

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In this week's episode of "Podnosis," we dive into a discussion with two founders of the Coalition for Health AI (CHAI). They share why both local providers and the federal government must play a role in overseeing AI in healthcare. 

Brian Anderson, M.D., CEO of CHAI, and Michael Pencina, Ph.D., COO of CHAI and Director of Duke AI Health, tackle the misconception that legacy tech giants can stifle startup competitors through the assurance lab model. They also share updates on the federal AI assurance lab network, revealed first to Fierce Healthcare. 

To learn more about the topics in this episode: 

• CHAI releases draft framework of quality assurance standards for healthcare AI
• UMass Chan Medical School, MITRE plan to open assurance lab to test healthcare AI
• HIMSS24: Microsoft, 16 health systems to operationalize AI under new partner network

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When it comes to health and wellbeing, good habits are everything. But forming habits is a challenge and maintaining them can be, too. 

To try to help, a growing number of healthcare companies are looking to incentivize consumers to take care of themselves more proactively by forming lasting healthy habits. One such company, Wellth, works with payers to keep their members engaged and healthier. 

In this week’s episode of “Podnosis,” Fierce Healthcare’s Anastassia Gliadkovskaya interviews Matt Loper, Wellth’s co-founder and CEO. She also chats with John Snyder, the former president and CEO of Sanford Health Plan, where he explains the return on investment the plan saw by working with a vendor like Wellth. 

To learn more about the topics in this episode: 

• Wellth reels in $20M to scale up its 'behavioral economics' approach to tackle chronic conditions
• How providers are leveraging patient engagement tools to close gaps in cancer screenings
• WebMD Ignite launches new member engagement platform for payers

See omnystudio.com/listener for privacy information.

In this week's episode of "Podnosis," we’re discussing the challenges and opportunities for telehealth, given some notable setbacks for the industry in recent months.

Fierce Healthcare's Noah Tong chats with Sanjula Jain, Ph.D., chief research officer for Trilliant Health, who shares her insights on why some telehealth companies are struggling, and how the industry can overcome the barriers to adoption.  

To learn more about the topics in this episode: 

• How the virtual care market is shaking out in 2024 as Walmart, Optum exit the telehealth business
• As Walmart shutters clinics, startup Fabric buys its MeMD telehealth business
• A look at telehealth's future and an omnichannel approach to care
• Optum layoffs: Ohio facility closing, 129 employees impacted
• Optum WARN filing: 524 workers in California laid off
• Teladoc posts $838M loss in Q2, lays out BetterHelp strategic pivot

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This week on “Podnosis” we're discussing a new payment model that could affect thousands of hospitals across the country. It's called TEAM, and it stands for Transforming Episode Accountability Model. It's a mandatory bundled payment program that covers five common procedures.

But what will it take for hospitals to prepare for the new payment model? How will they manage their clinical and financial risk and engage their patients and providers? And what can they learn from previous bundled payment models? To answer these questions, Fierce Healthcare's Anastassia Gliadkovskaya chatted with Brian Fuller, managing director of value-based care design and delivery at ATI Advisory, a consulting firm that helps healthcare organizations navigate the transition to value-based payment. 

To learn more about the topics in this episode:  

• CMS finalizes 2.9% pay bump for inpatient hospitals in FY2025
• CMMI seeks feedback for a new bundled payment model
• CMS proposes 2.6% bump to inpatient pay in fiscal 2025

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Many dermatologists are not trained to recognize skin conditions in people of color, which can lead to misdiagnoses and poor outcomes.

This week on "Podnosis," we dive into the topic of how to improve diversity and equity in dermatology. Fierce Healthcare's Anastassia Gliadkovskaya talked to Lisa O. Akintilo, M.D., a professor in the Ronald O. Perelman Department of Dermatology at NYU Langone Health. She is part of NYU Langone’s Skin of Color Section, a team of dermatologists that specialize in providing comprehensive treatments for skin conditions in people of color.  

To learn more about the topics in this episode: 

• VisualDx's diagnostic support tool to be available to all AMWA members 

• Eli Lilly expands ‘Get Better’ ad campaign to cover skin disease health equity 

• One year of VisualDx's Project IMPACT, a global effort to reduce skin color bias in medicine 

• Vaseline launches searchable platform of images to identify conditions affecting skin of color 

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Twenty years ago, the healthcare industry was still largely paper-based. The Office of the National Coordinator for Health IT was created back in April 2004 through an executive order from President George W. Bush. In the past two decades, major health IT policies pushed through by ONC and HHS have helped to move providers to a digital healthcare system that enables more effective data-sharing.    

Micky Tripathi, Ph.D., has spent most of his career in the health IT world and took the helm at ONC in January 2021. In this week’s episode of “Podnosis,” he chats with Executive Editor Heather Landi about ONC’s achievements over the past 20 years, the agency’s current top priorities, the rapid adoption of AI in healthcare and more.   

To learn more about the topics in this episode: 

• ONC's HTI-2 proposed rule 'big step forward' for interoperability, health IT experts say, but EHR vendors concerned about timelines
• HHS releases HTI-2 proposed rule to bolster public health, payer data sharing
• HHS pushes forward with new requirements for AI transparency, interoperability
• Hospitals, medical groups push back on ONC's 'excessive' and 'overly punitive' data blocking penalties

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In this week’s episode of “Podnosis,” Fierce Healthcare’s Anastassia Gliadkovskaya explores the topic of inequities in maternal and infant health and what one nonprofit is doing to increase transparency and accountability.

She chats with Kimberly Seals Allers, a journalist by background who is passionate about narrative storytelling. Seals Allers runs Birthright, a podcast highlighting positive Black birthing experiences, and is the founder of Irth, an app that collects and shares reviews of hospitals and doctors by Black and brown birthing people. Armed with those insights, Irth works with providers to identify areas for improvement and to close gaps in health equity. Today, the nonprofit collaborates with health departments, hospitals, and other organizations in nearly a dozen states.

To learn more about the topics in this episode:

• Providers rarely screen for maternal mental health. Are new guidelines enough to move the needle?
• Sweeping new study analyzes maternal health outcomes with SDOH, finds Black mothers at much higher risk
• BCBSA takes on racial, ethnic disparities in maternal care

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From 2020 to 2022, it was a wild ride for digital health with record-high deals and soaring valuations. But, the sector is maturing, and digital health players now have to change their game plan.  

In its first quarter funding report, Rock Health noted that it’s a new chapter for digital health funding. U.S. digital health funding closed with $2.7 billion across 133 deals in the first quarter, the lowest first quarter by sector funding since 2019.  

In this week’s episode of “Podnosis,” Executive Editor Heather Landi chats with Rock Health’s Megan Zweig to talk about the state of the market, how startups and investors are taking a different approach to dealmaking and what to expect for the rest of the year. 

To learn more about the topics in this episode:  

• More deal volume, lower check sizes for digital health in Q1, with AI investment leading the pack: Rock Health
• Digital health funding hit $10.7B in 2023, the lowest in four years. How will the market shake out?
• Digital health funding hit $5.7B through June, on track to surpass 2019 and 2023, Rock Health reports

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Join us for an insightful conversation with Dr. Heather Bassett, Chief Medical Officer at Xsolis, as she shares her unique journey from practicing hospitalist to healthcare technology innovator.

With over 20 years of healthcare experience, Dr. Bassett discusses how AI is transforming healthcare administration and reducing clinician burden. Drawing from her background in both medicine and technology, Dr. Bassett offers practical insights on AI implementation, navigating the generative AI hype cycle and the regulatory landscape ahead.

She also shares her vision for a healthcare system where technology enhances rather than hinders the patient-provider relationship, and provides valuable perspective on maximizing ROI from AI investments in healthcare.

Elsewhere, Dr. Bassett delves into Xsolis' approach to AI adoption since 2015, discussing how the company has moved beyond traditional machine learning to embrace generative AI responsibly. Here, she shares important considerations for healthcare organizations looking to invest in AI, emphasizing the need for strong leadership, comprehensive change management and patience in achieving results.

Whether you're a healthcare professional, technology leader or interested in the future of healthcare, this podcast offers essential insights into the responsible adoption of AI in clinical settings.

Tune in now!

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It is estimated that up to 20% of people globally are neurodivergent. Many neurodivergent individuals, including those with autism, have unique sensory needs. To best serve them in healthcare settings, the design of such spaces should ideally engage attention without overwhelming it. 

When Jefferson Health announced it would be building a new specialty care pavilion, Wendy Ross, M.D., saw an opportunity. As director of the Center for Autism & Neurodiversity at Jefferson, Ross understood the importance of thoughtful design. 

In this week’s episode of “Podnosis,” Fierce Healthcare’s Anastassia Gliadkovskaya interviews Ross about how she collaborated with co-workers, students and patients to test and incorporate innovative features into the new building, such as chairs with privacy screens and immersive artwork.

To learn more about the topics in this episode:  

• New virtual primary care provider for neurodivergent adults, Hopper Health, launches
• How behavioral health tech can help overcome adoption hurdles among neurodiverse populations

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An increasing number of employers are now offering fertility benefits. This is not only a cost-saving for employees but also serves as a way to attract and retain talent. Despite this positive trend for individuals starting their families, many LGBTQ+ individuals still feel unprepared to begin this journey. 

A recent survey from fertility benefits platform Carrot Fertility found that 85% of queer individuals feel confused, anxious and overwhelmed by the thought of building a family. For Pride month, Fierce Healthcare’s Anastassia Gliadkovskaya sat down with Carrot’s chief product officer James Wong to hear his personal family-building story and the unique challenges that queer couples face. They also talk about the role that care navigation plays for this population, especially amid the rapidly evolving legal landscape of reproductive healthcare in the United States.  

To learn more about the topics in this episode: 

• Wisp expands into fertility care with partners Proov, PherDal to offer at-home testing, insemination kits
• Maven beefs up fertility program with focus on natural conception, male fertility care
• Kindbody eyes expansion, AI investments in 2024. The question on investors' minds: Will the fertility startup go public?

See omnystudio.com/listener for privacy information.

In late February, UnitedHealth Group’s Change Healthcare unit faced a significant ransomware attack, sending shockwaves through the healthcare sector with far-reaching financial consequences.   

It has since come to light that the hackers exploited a vulnerability on a server lacking multi-factor authentication—a fundamental security measure.   

In this week’s episode of “Podnosis”, Senior Writer Paige Minemyer sits down with Clearwater CEO Steve Cagle to explore the lessons healthcare organizations can learn from the Change Healthcare cyberattack and what it reveals about the industry’s current state of security readiness.  

To learn more about the topics in this episode:  

• 'Cybersecurity is patient safety': What the ransomware attack on Change Healthcare should teach the industry

• UnitedHealth Group posts $1.4B loss in Q1 amid Change cyberattack fallout

• 'Too big to fail': Consolidation concerns loom over hearing on Change Healthcare cyberattack

• AMA weighing potential lawsuit over Change Healthcare cyberattack

See omnystudio.com/listener for privacy information.

This week on "Podnosis," we explore therapeutic psychedelics. Noah Tong from Fierce Healthcare sat down with Kim Chew, Senior Counsel at Husch Blackwell, to discuss the accessibility challenges in this promising but complex space. 

To learn more about the topics in this episode:  

• A look at psychedelics and the next frontier of mental healthcare
• Inside the breathtaking world of therapeutic psychedelics: Great promise and great challenges
• Benefits administrator Enthea makes ketamine-assisted therapy available nationwide
• AbbVie inks $2B-plus next-gen neuro deal with Gilgamesh
• PTSD treatment startup Stella acquires Field Trip's US assets to scale, takes over clinic operations

See omnystudio.com/listener for privacy information.

This week on "Podnosis," we dive into the topic of telehealth and its role in a comprehensive approach to healthcare.  

Emma Beavins from Fierce Healthcare interviews CVS Health Chief Medical Officer Sree Chaguturu, M.D., to talk about retail telehealth, CVS Health’s telehealth strategy and Chaguturu’s position as the chair of the American Telemedicine Association's board of directors.  

To learn more about the topics covered in this episode: 

• Walmart Health's shutdown underscores major challenges for retail health 'disruptors'
• Optum layoffs: Ohio facility closing, 129 employees impacted

See omnystudio.com/listener for privacy information.

In this week’s episode of “Podnosis,” we’re diving into the issue of generic drug shortages.  

Fierce Healthcare’s Dave Muoio sat down with Allan Coukell, policy head at the hospital-backed nonprofit drug supplier Civica Rx. Coukell sheds light on how these shortages are impacting healthcare providers' care and purchasing practices. He also provides insight into recent administration strategies aimed at bolstering drug supply chain resilience and offers immediate advice to organizations navigating these challenging shortages. 

To learn more about the topics in this episode: 

• HHS: Medicare incentives, penalties for hospitals could help stem drug shortages
• Number of ongoing US drug shortages reaches new high, pharmacist group says
• New bill aims to establish provider incentive program to combat drug shortages
• HHS, FTC want to know if GPOs, drug wholesalers are fueling generic drug shortages
• National medication, medical equipment shortages harming patients, ECRI survey finds

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In this week’s episode of "Podnosis," you'll hear from Paige Minemyer and Dave Muoio, two journalists from the Fierce Healthcare team. Together, they'll dive into first-quarter earnings updates from some of the largest health plans and health systems, sharing their key insights and the trends they've identified. 

To learn more about the topics in this episode: 

• UnitedHealth Group posts $1.4B loss in Q1 amid Change cyberattack fallout
• Community Health Systems logs expected Q1 net loss but beats on revenues
• Humana pulls back 2025 guidance following MA rate cut
• Tenet Healthcare's Q1 volumes, ASC additions, divestment proceeds are music to investors' ears
• UnitedHealth says seasonal pressures on MA utilization eased in Q1
• Cigna writes off $1.8B of its investment in Walgreens' VillageMD
• HCA Healthcare sails past Q1 estimates on strong volumes, but leaves full-year guidance untouched
• CVS' stock tumbles as Medicare Advantage pressures drag Q1 results
• Here's how major payers fared in a Q1 dragged by a cyberattack, MA challenges
• Centene offers look at its Medicaid strategy in 2024

See omnystudio.com/listener for privacy information.

More than 18 million veterans live in the U.S., making up about 7% of the adult population. Many of them encounter unique health challenges daily, often stemming directly from their military service.

Despite theoretically having access to care and services through the Department of Veterans Affairs, the reality falls far short of perfect. Crippling wait times, confusing benefits, and a lack of interoperability are just a few of the longstanding issues plaguing the veteran healthcare system.

In this week’s episode of “Podnosis,” Fierce Healthcare Senior Writer Anastassia Gliadkovskaya sits down with two experts experienced in navigating these challenges to discuss how stakeholders can overcome these barriers.

In the first segment, she chats with Jenn Kerfoot, Chief Strategy and Growth Officer at DUOS. Next, Anastassia interviews Stephanie Muckey, Population Health Strategy Lead for the Veteran Population at Humana.

To learn more about the topics in this episode: 

• Lawmakers grill VA, Oracle leaders over pharmacy-related patient safety issues
• Kaiser Permanente, UPMC among 13 major health systems to sign interoperability pact with VA

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Did you know about SciTech City, a developing mini city in Jersey City? It's quickly becoming a hub for investment, although it might not be widely known yet. SciTech City, anchored by the Liberty Science Center, is set to expand with plans for a new public STEM high school, tech-oriented housing and a health innovation hub focused on wellness.

Key partners like Bristol Myers Squibb, Sheba Medical Center from Israel, and now RWJBarnabas Health have joined the project. RWJBarnabas Health will collaborate on designing the health innovation hub, showcasing cutting-edge technologies for SciTech City and beyond.

Anastassia Gliadkovskaya recently spoke with Eyal Zimlichman, M.D., the head of Sheba's innovation program and founder and director of ARC Innovation, to dive into the details of this unique initiative.

To learn more about the topics in this episode: 

• New Aegis Ventures consortium joins 9 health systems to co-develop digital solutions
• New Mayo Clinic program to qualify, integrate digital health offerings into clinical care

See omnystudio.com/listener for privacy information.

An estimated 17 million adults in the U.S. had long COVID as of March of this year. Despite the prevalence of this condition, there is still much that is unknown about its causes, symptoms and potential treatments. However, to help those suffering from long COVID, specialized clinics are emerging throughout the country.   

In Detroit, Moderna, People.Health and community organizations have opened a mobile clinic to provide free lung CT screenings. The clinic aims to evaluate patients for possible lung damage caused by various risk factors and gather anonymous data, with patients' consent, for an ongoing study on long COVID.  

In this week's episode of "Podnosis," Anastassia Gliadkovskaya interviews two executives involved in the project: James Mansi, Vice President of Medical Affairs, North America, at Moderna, and Sandra Carey, President of People.Health. They discuss how the clinic collaborates with community-based organizations and other healthcare providers to carry out its work. They also explore the crucial role of mobile clinics in building trust, creating awareness and detecting diseases early.

To learn more about the topics in this episode: 

• Moderna embarks on new vax push in long COVID prevention campaign
• Long COVID described as a 'syndrome of syndromes' in NIH funded research
• New AI-driven long COVID app coming soon to individual, enterprise customers

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Interoperability has been a major focus in healthcare for the past decade. It is crucial for systems to be able to talk to one another. A patchwork of laws allow for health data sharing today through electronic health record systems and health information exchanges.

But some states believe there are situations where sharing sensitive health data may actually do more harm than good. Since the overturning of Roe v. Wade, Maryland has been thinking deeply such scenarios and to that end, passed a law to protect reproductive health data. To understand it, Anastassia Gliadkovskaya speaks to Nichole Sweeney, general counsel and chief privacy officer of the state’s designated HIE, CRISP Shared Services.  

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After the dissolution of its joint venture with Amazon and Berkshire Hathaway called Haven, JPMorgan Chase formed a new division, Morgan Health, to continue pushing for reform in the industry. Morgan Health has invested in multiple businesses over the past three years that can potentially improve employer-sponsored healthcare.  

This week on “Podnosis,” Paige Minemyer from Fierce Healthcare interviews Morgan Health Partner Dan Hartman about the company's investment strategy and how to make a memorable pitch. 

To learn more about the topics in this episode: 

• JPMorgan launching business arm to address cost, quality of employer healthcare
• Virgin Pulse, HealthComp to merge in $3B deal aimed at improving employer health
• Morgan Health, Kaiser Permanente partner on health equity
• Morgan Health unveils policy platform, pushes for value-based care in employer market

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This week on "Podnosis," we are exploring a topic that hits close to home for many: the struggles faced by LGBTQ+ patients, particularly trans men, when seeking healthcare services.  

A patchwork of federal and state laws exists to protect gender-diverse patients, to some extent, from discrimination in the healthcare setting. But even when such protections exist on paper, they are not guaranteed in practice.  

To unravel the complex legal landscape that providers and LGBTQ+ patients are attempting to navigate, Anastassia Gliadkovskaya, senior writer at Fierce Healthcare, interviewed Sasha Buchert, a senior attorney at Lambda Legal. 

To learn more about the topics in this episode: 

• Denied care: Trans men struggle for inclusive gynecologic healthcare
• LGBTQ+ founders reflect on the struggles of fundraising, seeking allies and pleasing investors
• LGBTQ+ adults more likely to delay, avoid care, Healthgrades survey finds

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Social prescribing is an emerging movement in healthcare, where providers may recommend personalized doses of arts and culture as part of a comprehensive care plan.

Fierce Healthcare’s Anastassia Gliadkovskaya sat down with two leaders in this space to discuss the power of the arts and their role in the next generation of mental health treatment.

To learn more about the topics in this episode: 

• Breaking down barriers with adaptive recreation
• Industry Voices—Let's treat loneliness like other public health crises
• Elevance Health research outlines ways health plans can fight loneliness in MA beneficiaries

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In an evolving healthcare landscape, organizational agility and resilience are paramount. In this episode, Mary Jo Williamson, Chief Administrative Officer at Mayo Clinic Laboratories, provides invaluable insights on how healthcare organizations can navigate change while staying true to their mission.

During the conversation, Williamson highlights the importance of connecting people to the organization's core values through consistent language and storytelling, celebrating living examples that reinforce the mission. She also advocates for setting expectations for change, employing scenario planning and creating a framework that allows for adjusting strategies and initiatives as new information emerges.

Remaining resilient amid a backdrop of constant change, Williamson explains, requires a thorough understanding of team challenges, the provision of ample resources, the creation of a sense of purpose and a fostering of a culture of optimism.

Tune into the full discussion to discover more.

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This week on “Podnosis,” we explore the pressing questions surrounding AI’s role in healthcare. From clinician trust to algorithm accuracy and patient privacy, there’s significant uncertainty about AI’s potential and impact in the healthcare sector, a topic that garnered considerable attention at this year’s South by Southwest conference. 

During the annual event, American Medical Association President Jesse Ehrenfeld, M.D, and Claire Novorol, co-founder and CMO at Ada Health, both participated in a panel discussion on the future of AI in healthcare. Fierce’s Anastassia Gliadkovskaya caught up with them after the panel to gain further insights, and you’ll have the opportunity to hear those conversations in this week’s episode. 

To learn more about the topics in this episode: 

• Google's healthcare AI ambitions: New model for personal health coaching and next steps for gen AI
• How Epic is building out AI, ambient technology for clinicians
• As AI adoption in healthcare grows, Senate lawmakers weigh regulation, payment approaches

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This week on “Podnosis,” we explore the dynamics surrounding the financial distress gripping hundreds of hospitals nationwide. Despite the perilous situation, there has been a notable increase in merger and acquisition activity, suggesting that amid the chaos, opportunities for value creation and strategic partnerships still exist. 

Joining us for this deep dive is Michael Abrams, managing partner at the healthcare consulting firm Numerof & Associates. In a conversation with Dave Muoio of Fierce Healthcare, Michael provides insights into the current healthcare landscape, shedding light on the considerations that potential buyers evaluate when eyeing distressed hospital assets. 

To learn more about the topics in this episode: 

• Financial distress fueled more hospital M&A deals in 2023, report finds
• Half of rural hospitals are losing money. Rising MA enrollment likely won't help them, Chartis warns
• Operating pressures, rising demand ensure dealmaking will hold steady in 2024, KPMG says
• Federal regulators, clinicians make their case against private equity in healthcare
• 'Innovative' NJ hospital merger marries for-profit with nonprofits to preserve safety-net care

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In this week’s episode of "Podnosis," you'll hear from two journalists from the Fierce Healthcare team: Paige Minemyer, senior editor of Fierce Health Payer, and Dave Muoio, a staff writer for Fierce Healthcare. Together, they'll dive into the most recent earnings updates from the largest health plans and health systems, sharing their key insights and the trends they've identified. 

To learn more about the topics in this episode: 

• UnitedHealth Group's stock stumbles as it reports spike in utilization for Q4
• Strong demand, higher per-patient revenues propel HCA Healthcare in Q4 2023
• Despite pockets of higher utilization in Q4, Elevance Health execs say trends aligned with expectations
• Universal Health Services beats on earnings, revenues and projects 'conservative' earnings growth for 2024
• Despite 'significant progress,' Providence ends 2023 with $1.2B operating loss
• Kaiser Permanente reports $4.1B profit, exceeds $100B operating revenues in 2023
• Trinity Health nearly wipes last year's operating losses, grows revenue by over 11%
• Despite sale of its MA business, Cigna CEO says the market is still 'attractive'
• Medicare Advantage headwinds didn't prevent payers from turning a profit in 2023
• Community Health Systems discloses DOJ investigation
• UPMC reports almost $200M operating loss as expenses rise
• CommonSpirit Health's finances trend upward thanks to higher volumes, efficiency push
• Humana reaffirms 2025 guidance as CMS pitches decrease in MA benchmark payments
• Tenet Healthcare shares M&A updates, projects above-guidance 2023 earnings
• Ascension escapes last year's losses with higher per-patient revenues, tempered cost growth
• Mayo Clinic closed out 2023 with $18B in revenue, 6% operating margin
• Mass General Brigham reports $82M operating gain even as expenses continue to bite
• CVS cuts 2024 outlook amid rise in medical costs in Q4

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This week on “Podnosis,” Fierce Healthcare’s Anastassia Gliadkovskaysa sits down with NeuroFlow Chief Medical Officer Tom Zaubler, M.D., to discuss the barriers to the widespread adoption of measurement-based care in behavioral health. 

To learn more about the topics in this episode: 

• 2024 Outlook: How tech, incentives could push measurement-based care in behavioral health
• Few therapists measure outcomes. A startup's new framework aims to change that
• Industry Voices—Innovative mental healthcare practices are hampered by access challenges, administrative burdens

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This week on “Podnosis,” we explore the critical issue of maternal mental health. 

Ayla Ellison, Editor-in-Chief of Fierce Life Sciences and Healthcare, sits down with Ken Levey, M.D., co-founder and CEO of Mother Goose Health. Together, they explore the deficiencies in maternal mental health care in the U.S. and discuss actionable steps for improvement. Mother Goose Health provides a platform aimed at aiding physicians and patients in initiating care and identifying pregnancy-related risks, including those associated with mental health. 

To learn more about the topics in this episode: 

• Providers rarely screen for maternal mental health. Are new guidelines enough to move the needle?

• Maternal death rates nearly doubled in 2 decades, study finds. Inconsistent data collection also hampers improvement efforts

• Sweeping new study analyzes maternal health outcomes with SDOH, finds Black mothers at much higher risk

• One in 5 mothers mistreated during maternity care, nearly half withhold concerns, CDC reports

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How can healthcare organizations face up to the growing threat posed by cybercriminals? What tangible steps can they take to bolster their defenses? 

Brian Arnold, Director of Legal Affairs at Huntress, joins the podcast to provide valuable insights and actionable strategies for healthcare organizations seeking to navigate the complex cybersecurity landscape and protect themselves against evolving threats. Such threats, Brian outlines, include phishing attacks, social engineering, and the worrying rise of ransomware incidents.

However, there are ways to turn the tide. Building a strong team of defenders, implementing basic cybersecurity hygiene practices, and leveraging cybersecurity products tailored to the healthcare industry… these are all actions which can make a real difference. And they need not break the bank either.

Throughout the conversation, Brian also underscores the critical role of leadership buy-in, employee training, and collaboration with cybersecurity experts in safeguarding patient data and ensuring compliance with regulatory requirements.

Want to learn more? Tune in to the full discussion now.

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American Specialty Health Incorporated's ASH Care fall prevention program offers virtual assessments and exercise regimens to address falls among older adults. The program combines remote physical therapist evaluations, personalized exercise plans and coaching to improve balance and strength while reducing fall risks. Initial results show 60% to 75% of participants experienced improvements in outcome measures, with statistically significant gains in balance, strength and reduced fear of falling. ASH Care aims to enhance older adults' health and independence while potentially lowering healthcare costs associated with fall-related injuries.

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In the U.S., where the healthcare sector emits significantly more carbon emissions than the aviation industry, hospitals are starting to think about ways to address their climate footprint. 

This week on "Podnosis," Estelle Monod, who leads the global buildings segment at Schneider Electric, sits down with Fierce Healthcare's Anastassia Gliadkovskaya to talk about the sustainability needs of the healthcare sector and ways to address them. 

To learn more about the topics in this episode: 

• A 'reckoning' in healthcare: The climate crisis and what the industry can do about it
• Joint Commission announces sustainability certification program for hospitals
• Fierce 50 Social Impact Category

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Every year, Fierce Healthcare's editorial team sifts through hundreds of nominations to identify 15 companies that are truly making waves in the healthcare sector, striving to change the world by changing the industry. The 2024 class of Fierce 15 honorees is no exception, taking on some of the most pressing challenges in healthcare today. 

This episode features a conversation with Fierce Healthcare's Paige Minemyer, Dave Muoio and Noah Tong. They share insights into this year's Fierce 15, discussing the companies that made the cut and the significant issues they are addressing.  

To learn more about the topics in this episode: 

• Fierce Healthcare's Fierce 15 of 2024

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This is the second part of our series reconnecting with Fierce 15 winners from 2019, the first year Fierce Healthcare published the list of 15 private companies engaged in pioneering work  

This week on "Podnosis," we catch up with the leaders of Elemeno Health and Digital Diagnostics, both recognized as Fierce 15 winners in 2019.

First up, Fierce’s Anastassia Gliadkovskaya chats with Arup Roy-Burman, M.D., the founder and chief medical officer at Elemeno Health. Roy-Burman reflects on Elemeno’s evolving mission to democratize information and its entry into new markets, accelerated by the COVID-19 pandemic. 

Next, Fierce’s Noah Tong catches us up with Digital Diagnostics. The Iowa-based company rose to prominence because of its AI system that enabled a specialist diagnosis for diabetic retinopathy in a primary care setting. Noah interviews CEO John Bertrand about the company’s global expansion, its approach toward value-based care and the future of AI. 

To learn more about the topics in this episode: 

• Fierce Healthcare's Fierce 15 of 2019

• Digital Diagnostics dials up $75M funding for diabetic retinopathy AI 

• Baxter taps Digital Diagnostics' diabetic retinopathy AI for its Welch Allyn eye scanners 

• Microsoft, Wolters Kluwer collaborate on 'big picture insights' analytics offering for hospitals 

• Privia Health joins forces with AI startup Navina for point-of-care clinical insights 

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This week on “Podnosis,” we rewind to January 2019 when Fierce Healthcare unveiled its inaugural Fierce 15, spotlighting 15 private companies engaged in pioneering work and making waves in healthcare innovation. 

In this episode, we reconnect with leaders from two of those companies: Cityblock Health and Civica Rx.

Fierce Healthcare Senior Editor Heather Landi chats with Kameron Matthews, M.D., the Chief Health Officer at Cityblock Health. From its beginnings with a single neighborhood hub to now operating in six markets and caring for more than 100,000 patients, we explore Cityblock’s journey and lessons learned in providing care to medically underserved populations. 

Next, Fierce Healthcare’s Noah Tong interviews Civica Rx CEO Ned McCoy, who takes us through Civica Rx’s journey over the last few years—from its formation in 2018 to now working with 1,500 member hospitals across the U.S. 

To learn more about the topics in this episode: 

• Fierce Healthcare's Fierce 15 of 2019
• JPM24: Cityblock inks partnership with Centene plan in Ohio to serve Medicaid patients
• Fierce 50 Health Equity Honoree: Kameron Matthews
• Group of US hospitals officially launches nonprofit generic drug company as Civica Rx 
• Civica Rx taps Ned McCoy as new CEO
• Civica Rx to make, distribute low-cost insulin

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