The Gist Healthcare Podcast

Milwaukee, Wisconsin-based Ascension Columbia St. Mary’s Hospital is postponing non-urgent surgeries for 30 days amid a staffing shortage. The CDC and FDA report a possible link between Pfizer's bivalent Omicron booster and strokes in people over 65. And, the state of California sues pharmacy benefit managers and drug makers over the cost of insulin. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The healthcare industry has experienced a lot of challenges and seen a lot of innovations over the last year. On today's episode of Gist Healthcare Daily, Gist Healthcare co-presidents Chas Roades and Dr. Lisa Bielamowicz joined the podcast to give their take on what healthcare could look like in 2023.  Hosted on Acast. See acast.com/privacy for more information.

The Biden Administration extended the COVID public health emergency again this week--potentially for the final time. The Department of Health and Human Services announced key implementation dates for Medicare drug price negotiations. And, insurtech companies outline their priorities for 2023 and beyond. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

A federal judge has ruled that HHS can create its repayment plan to 340b hospitals to the dismay of hospital lobbying groups. Intermountain Healthcare is partnering with Colorado’s UC Health to create a combined clinically integrated physician network in in the state. And, the U.S. healthcare sector added 55,000 jobs in December. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Tech-enabled primary care provider Carbon Health has secured $100 million dollars in new funding from CVS Health. Digital health funding declined significantly in 2022 after breaking records in 2021.  And, the American Academy of Pediatrics is now recommending early intervention for childhood cases of obesity. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Gist Healthcare joins healthcare management consultancy group Kaufman Hall. Biogen’s latest Alzheimer’s drug lecanemab was granted accelerated approval by the FDA. And, the FTC has proposed a ban on non-compete agreements, which could impact how the healthcare industry operates. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

In 2022, CommonSpirit–the second largest hospital chain in the United States–was the target of a ransomware attack that hobbled operations at many of its 140 hospitals and exposed the private health information of more than 600,000 patients. The attack on CommonSpirit was the largest ransomware attack in 2022 but it was hardly an isolated incident. One analysis found that up to 290 hospitals in the U-S were impacted by a ransomware attack last year. And a new study published in JAMA found that from January 2016 to December 2021, 374 ransomware attacks on US health care organizations exposed the private health information of nearly 42 million patients. So what can hospital systems do to better protect themselves and their patients? On today’s episode of Gist Healthcare Daily, J. Carlisle Larsen is joined by Steve Cagle–CEO of Clearwater, a firm that provides cybersecurity, compliance, and privacy solutions focused on the healthcare industry. Hosted on Acast. See acast.com/privacy for more information.

One in three Americans had a mental illness or substance use disorder in 2021, according to a new survey. OSHA is expected to release its final COVID-19 safety guidelines for healthcare workers this month. And, New York is one of the latest states to require co-prescribed naloxone for some patients using opioids. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

An FDA rule change would allow retail pharmacies to provide prescription abortion pills. Some states that banned abortions are now weighing Medicaid expansion for new mothers. And, the Department of Health and Human Services has issued a proposed rule that changes how the healthcare sector handles conscience and religious objections. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

A new Omicron variant is quickly spreading through the United States. A new Congressional report finds irregularities with the FDA’s accelerated approval for the Alzheimer’s drug Adulhelm. And, medical bill disputes between payers and providers are overwhelming the resolution system set up following the No Surprises Act. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Congress’ year-end spending bill has been finalized and includes changes to the FDA’s accelerated approval process. A new study finds high-intensity billing in emergency departments is increasing but it’s not just due to upcoding. And, the Biden Administration will release flu medicine from the national stockpile as the rate of infections increases. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The Joint Commission is eliminating some of its quality standards as it seeks to streamline hospital safety and quality goals. The Biden Administration will publish ownership data for all hospitals that participate in Medicare.  And, parents in the U-S are struggling to find pediatric beds for kids sick with RSV or the flu. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Congress reportedly has reached a deal that would ease cuts to Medicare physician payments in 2023. Payers will need to provide an online-based price comparison tool as part of a the latest CMS requirements going into effect on January 1st. And, online pharmacy Truepill could be in trouble with the DEA over allegations that it unlawfully dispensed stimulants for ADHD. Hosted on Acast. See acast.com/privacy for more information.

Blue Cross Blue Shield of Massachusetts is including health equity measures in new value-based payment contracts. The Biden Administration seeks to extend opioid treatment flexibilities put in place through the COVID-19 public health emergency.  And new data shows that overall U.S. healthcare spending slowed in 2021 as federal COVID funding subsided.  That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Two west coast nonprofit managed care insurers announced merger plans. Blue Cross Blue Shield of Michigan has struck new full-risk Medicare Advantage contracts with six large physician groups. And, a new study finds that emergency department physicians misdiagnose serious conditions when patients exhibit unusual symptoms. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The CDC says long COVID is responsible for thousands of deaths in the U.S. More for-profit healthcare organizations are reportedly at risk for credit default…with the vast majority of those being owned by private equity firms. And, new data shows the staffing challenges facing many not-for-profit hospital systems may be easing slightly. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

HHS signaled that healthcare systems can rely on COVID-19 public health emergency flexibilities as flu and RSV cases strain hospitals. CMS is proposing big changes to health insurance exchanges. And, researchers find that the COVID-19 vaccine saved the U.S. healthcare system more than $1 trillion. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

A federal appeals court has struck down a Biden Administration policy protecting gender-affirming care under the Affordable Care Act’s nondiscrimination regulations.  A Montana law barring employers from mandating COVID-19 vaccines has been deemed unconstitutional in healthcare settings.  And, a new California law could bring more scrutiny to healthcare mergers & acquisitions. That's all coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The FDA has authorized the use of the Omicron-specific bivalent booster in children as young as six months. University of Michigan Health announced it will acquire Sparrow Health. And, a new study evaluates the risks of seniors undergoing major surgery. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Employers across the US are expecting a spike in health care costs in 2023. Mark Cuban Cost Plus Drug Company has partnered with the Purchaser Business Group on Health, a large employer coalition. And, former-Theranos executive Sunny Balwani has been sentenced to prison after being convicted for fraud. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

CMS is proposing a new rule to streamline prior authorization for payers. UnitedHealth Group’s proposed $5 billion acquisition of a home health provider is on pause. And, new research finds the incidence of heart inflammation following a COVID-19 vaccine is very low among young people. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Congress will likely repeal a COVID-19 vaccination mandate for US armed service members, despite opposition from the White House. New research finds that as many as 18 million Americans may lose their Medicaid coverage once the COVID-19 public health emergency ends. And, flu-related hospitalizations are on the rise. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The nation’s largest for-profit health systems had their best operating margins during the COVID-19 pandemic. Several physicians groups have filed a legal brief in support of the ACA’s preventive care provision as it’s being challenged in federal court. And, Pfizer has applied for FDA emergency use authorization for its Omicron booster in children under the age of five. That's all coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Atrium and Advocate Aurora have finalized their merger, creating the fifth-largest nonprofit health system in the country. A soon-to-be implemented California law aimed at stopping physicians from spreading medical misinformation is already being challenged in court. And, the FDA will ease some donor restrictions amid a national blood shortage. Hosted on Acast. See acast.com/privacy for more information.

A study finds that the post- ACA drop in hospital readmissions may actually be due to how systems classified patient stays. A proposed House bill aims to reform how Medicare covers certain drugs. And, researchers may be one step closer to developing a universal flu vaccine. That's all coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

A new Alzheimer’s drug has shown promise in slowing cognitive decline in Phase 3 clinical trials but concerns remain about its safety. Former MetroHealth CEO Akram Boutros is suing the hospital system and its board of trustees for violating Ohio’s Open Meetings Act--and its own bylaws--when it fired him. And Twitter has quietly stopped enforcing its COVID-19 misinformation policy. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Research finds that so-called “skinny labeling” which allows drug makers to sell generics for off-patent use saved Medicare around $1.5 billion, but a legal fight could upend the practice. The Center for Medicare and Medicaid Services new Direct Contracting Model saved the agency $70 million during its inaugural year. And CMS is warning hospital systems to do more to protect staff and patients. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Greater numbers of Americans are buying health insurance on the ACA exchanges during the current open enrollment period. The WHO has changed the name of the “monkeypox” virus to “mpox”, following criticism that the former name exacerbates stigma. And several large health systems are now charging patients for some communications with their physicians through online patient portals. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

There are significant disparities along racial lines in the orthopedic speciality field. Black patients are 30% less likely to undergo total hip and knee replacements compared to white patients, even though rates of arthritis remain close to the same between the two groups. And those racial disparities extend to the field of orthopedic surgeons with fewer than 2% of Black orthopedic physicians practicing in the United States.  On today's episode, we replay our conversation with Dr. Alonzo Sexton--co-founder and CEO of ATL Orthopedics. He joined Gist Healthcare Daily to talk more about his private practice and how it makes orthopedic care more accessible to an underserved community. Hosted on Acast. See acast.com/privacy for more information.

The state of Georgia may enforce work requirements for residents to qualify for expanded Medicaid. The longtime CEO of Cleveland-based MetroHealth was fired over nearly $2 million in alleged unauthorized bonuses that he gave to himself. And Bellin Health and Gundersen Health System are on track to finalize their merger at the end of this month. That's coming up on today's Gist Healthcare Daily. As a note to listeners, the podcast will be taking a short break this week for the Thanksgiving holiday. Hosted on Acast. See acast.com/privacy for more information.

The recently closed merger of UnitedHealth Group and Change Healthcare could be in jeopardy after the Department of Justice submitted an appeal to an earlier judge’s decision to allow it to move forward. A coalition of states is calling on CMS to drop its vaccine mandate for healthcare workers. And former Theranos CEO Elizabeth Holmes was sentenced to prison last week. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

There are significant disparities along racial lines in the orthopedic speciality field. Black patients are 30% less likely to undergo total hip and knee replacements compared to white patients, even though rates of arthritis remain close to the same between the two groups. And those racial disparities extend to the field of orthopedic surgeons with fewer than 2% of Black orthopedic physicians practicing in the United States.  On today's episode, Dr. Alonzo Sexton--co-founder and CEO of ATL Orthopedics--joins Gist Healthcare Daily to talk more about his private practice and how it makes orthopedic care more accessible to an underserved community. Hosted on Acast. See acast.com/privacy for more information.

Big names in the healthcare and tech world flocked to Las Vegas this week for the fifth annual HLTH Conference. Big tech companies like Google and Uber are looking to take an expanded role in the healthcare industry, government officials want to strengthen public-private partnerships, and more.  Hosted on Acast. See acast.com/privacy for more information.

Pediatric physicians are urging the Biden Administration to declare a national and public health emergency as respiratory illnesses are leading to a surge in hospitalizations among children. Walmart will pay $3 billion as part of a multi-state opioid lawsuit. And virtual care company Hims & Hers secures another health system partnership. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Amazon unveiled its new virtual care platform–Amazon Clinic–which will treat non-urgent consumer health needs. Two large regional health systems in the upper midwest announced they plan to merge in a $14-billion deal. And 21,000 nurses will strike at 21 Kaiser Permanente facilities in California next week. That's all coming up on today's episode o Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The federal COVID-19 public health emergency will likely continue through early April. Moderna released its latest efficacy finding for its updated Omicron booster. And emergency room physicians across the country say that ERs are at the breaking point and are asking for relief from the Biden administration. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

It’s been less than a week since voters went to the polls across the country to cast their ballots in the 2022 Midterm Elections. Gist Healthcare leaders–CEO Chas Roades and President Dr. Lisa Bielamowicz–join the podcast today to talk about how healthcare played a role in this year’s election and what we can expect from 2024.  Hosted on Acast. See acast.com/privacy for more information.

Physicians at one of the largest teaching hospital systems in New York City announced they are unionizing. Insurtech companies–Bright Health Group and Oscar Health–are scaling back their Medicare Advantage plan offerings. And the Supreme Court signals it won’t gut a law that allows Medicaid recipients to sue over benefits. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Healthcare was on the ballot in several places Tuesday - South Dakota became the latest state to expand Medicaid coverage through a ballot measure, abortion access became a driving force at the polls, and a new law in Arizona regulating how collections agencies collect medical debt could set a precedent for other states. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Mass General Brigham joins other health systems in adopting a code of conduct for patients. A new study aims to prove–or disprove–the prevailing hypothesis about the cause of Alzheimer’s. And the Center for Medicare and Medicaid Innovation updates its strategy for implementing value-based care. That's all coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

A group of orthopedic surgeons who broke away from a Wisconsin system are opening a new independent practice - managed by a national private-equity backed chain.  After a rough 2022, hospital closures could rise next year. And a new report finds that the commercial insurance market lacks competition in many states.  That's all coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Pfizer and BioNTech share promising new data on the efficacy of their bivalent booster, despite smaller studies to the contrary. The CDC reports that nearly 84% of pregnancy-related deaths could be prevented. And a new analysis shows that most Medicare beneficiaries don’t compare plans during the annual open enrollment period. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Physicians groups are gearing up to lobby Congress over pay cuts from CMS. Medicare fines for hospital readmissions declined last year but a number of hospitals were still penalized. And New York and California are hotspots for the new BQ strains of the COVID-19 virus and it could soon spread to the rest of the country. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

CMS released its final payment rules for 2023 this week and physician reimbursement is set to decline. An FDA advisory panel found that pulse oximeters may be inaccurate on Black and brown patients. And CVS and Walgreens have agreed to a $10 billion deal to settle thousands of opioid lawsuits brought against them.   Hosted on Acast. See acast.com/privacy for more information.

Pfizer announced the clinical trial of its bivalent vaccine for RSV was successful in protecting infants from the illness. A merger could be in the works for Summit Health and Walgreens-backed Village MD. And new data show who’s affected most by long-COVID. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Open enrollment for the Affordable Care Act insurance marketplace starts today. CVS Health is partnering with a startup to provide customers with more at-home self-diagnostic tests.. And the amount of money spent on health care lobbying has jumped 70% over the last two decades. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

While the cost of employer-sponsored health insurance didn’t really change between 2021 and 2022, it'll likely increase next year once inflation is factored in. The majority of U.S. states have now expanded their postpartum Medicaid coverage from 60 days to one year. And a new survey finds that nearly half of Americans are in debt due to medical bills. That's on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Walmart Health plans to open 16 more health centers in Florida next year. Amazon Pharmacy inks a deal with another Blues plan to deliver prescriptions to beneficiaries. And CMS will restrict Medicare Advantage TV ads next year amid complaints that they are confusing. That’s all coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The Affordable Care Act’s preventive care coverage could be in legal jeopardy. Digital health funding is cooling after a banner year in 2021.  And a new report finds 117,000 physicians left the healthcare workforce last year. That's on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The U.S. Department of Health and Human service is challenging Merck over its non-compliance with the 340B program. Mental telehealth provider Cerebral is laying off 20% of its workforce. And two healthcare providers have announces a new virtual and in-home care company. That’s on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.