The Gist Healthcare Podcast

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.

Two large, publicly-traded hospital systems are reporting a drop in profits. A capitated primary care provider for self-insured employers plans to expand to payer clients. And flu cases are already trending higher this year. That's on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Hospitals across the country are being overwhelmed with cases of young children diagnosed with a common respiratory virus. A new report finds a majority of hospitals are now complying with price transparency rules. And new data show a link between COVID-19 and an increase in pregnancy-related deaths in the U.S. That's coming up on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

An FDA committee has voted to pull a preterm birth prevention drug from the market, which had been approved through its controversial accelerated approval program. A CDC panel recommends providing free COVID vaccines to lower-income children. And a large insurer will now cover some software-based therapies for psychiatric and other conditions. That's on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

A new survey shows the widespread impact of the current labor shortage on hospital operations. Walgreens and CVS face a federal probe over allegations that pharmacists refused to fill prescriptions for medications that could harm a pregnancy. And consumers can now purchase hearing aids over-the-counter. That's on today's episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

On today's episode of Gist Healthcare Daily: some Medicare Advantage payers may see less revenue after being hit with star ratings downgrades. The US Department of Justice is suing Cigna over allegedly upcoding MA patients via in-home assessments. And Walgreens is looking to acquire a tech asset next.  Hosted on Acast. See acast.com/privacy for more information.

Telemedicine provider Babylon Health has announced plans to sell its California IPA business.  Providence is being investigated in Oregon for consumer protections violations stemming from its financial and billing practices. And two midwest healthcare systems are investigating a possible merger. That’s all coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

One of the largest hospital chains in the United States confirmed that it was the target of a ransomware attack. A new study is casting doubt about the efficacy of colonoscopies. And a major insurtech company is drastically reducing its presence in the marketplace. That’s all coming up on today’s episode of Gist Healthcare Daily. Note: this episode has been updated to clarify a statistic in the colonoscopy study story. Hosted on Acast. See acast.com/privacy for more information.

The migration of procedures away from hospital inpatient departments preceded the pandemic, but COVID accelerated that shift. This is most obvious among orthopedic procedures like hip and knee replacements. Gist Healthcare partnered with Stratasan, a Syntellis-owned healthcare data analytics firm providing market intelligence for strategic planning, to quantify how much much knee and hip replacement procedure volume is moving outpatient. A detailed infographic about this shift will be published on GistHealthcare.com later today. Stratasan's Senior Product Manager Michael Shipley joins the podcast to discuss the findings of the data analysis, where the volume is migrating, and how this impacts hospital systems.This is host Alex Olgin's last podcast episode. The podcast will be taking a break as we hire and train a new host, but we're planning to be back with new episodes in September. Hosted on Acast. See acast.com/privacy for more information.

On this episode of Gist Healthcare Daily, federal health officials adopt a new monkeypox vaccine strategy to stretch doses. TikTok parent company, ByteDance, acquires a Chinese hospital chain. And US hospital CEO's are leaving their positions at high rates. Hosted on Acast. See acast.com/privacy for more information.

On this episode of Gist Healthcare Daily, hospitals in states with strict abortion laws struggle to recruit physicians. CivicaScript starts selling its first outpatient generic drug to treat prostate cancer. And a new study published in Nature Climate Change finds climate change is exacerbating some infectious diseases. Hosted on Acast. See acast.com/privacy for more information.

On this episode of Gist Healthcare Daily, the Senate passes a bill with major reforms for seniors on Medicare. A new NPR, the Robert Wood Johnson Foundation, and Harvard TH Chan School of Public Health poll finds a fifth of sick patients weren’t able to get necessary medical care. And there are rumors that CVS is interested in acquiring Signify Health. Hosted on Acast. See acast.com/privacy for more information.

On this episode of Gist Healthcare Daily, Kansas voters rejected a ballot measure that would have overturned a constitutional right to abortion. Medicare raises payment rates for hospitals next year. And the highly consolidated dialysis industry could spell problems for Medicare Advantage plans. Hosted on Acast. See acast.com/privacy for more information.

In this episode of Gist Healthcare Daily, the trial challenging UnitedHealth Group’s acquisition of Change Healthcare starts this week. Hospitals look beyond pay to retain employees. And New York alleges CVS Health of preventing hospitals from obtaining 340B discounts. Hosted on Acast. See acast.com/privacy for more information.

Earlier this month, Morgan Health invested $30M in Centivo, an innovative health plan for self-insured employers. In this episode, we hear from Dan Hartman, Executive Director at Morgan Health, and Ashok Subramanian, CEO of Centivo, about how Centivo plans to leverage the Morgan investment to expand its services.   Hosted on Acast. See acast.com/privacy for more information.

On this episode of Gist Healthcare Daily, Democrats reach a deal on a healthcare and climate bill. More than 40 percent of parents of kids under 5 say they won't get their child vaccinated for COVID-19. And after years of sky high travel nurse wages, the market is starting to return to normal. Hosted on Acast. See acast.com/privacy for more information.

On this episode of Gist Healthcare Daily, the Biden Administration reinstates and expands Affordable Care Act nondiscrimination protections. In a rare move, nurses at a Mayo Clinic hospital decertify their union. And the White House estimates it could cost up to $7B to adequately respond to the growing monkeypox outbreak. Hosted on Acast. See acast.com/privacy for more information.

On this episode of Gist Healthcare Daily, a challenge to the Affordable Care Act's preventive care requirement is in front of a Texas federal court. Hospitals are still struggling to rein in labor costs. And the Wall Street Journal takes the latest look at how nonprofit hospitals lag on charity care. Hosted on Acast. See acast.com/privacy for more information.

On today's episode of Gist Healthcare Daily, providers await Medicare’s plan to remedy 340B reimbursement cuts. The White House is revamping its booster strategy. And racial disparities persist across insurance coverage. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Gist Healthcare co-founders Chas Roades and Lisa Bielamowicz discuss how the deteriorating economy and increased margin pressures are creating significant challenges for health systems. Hosted on Acast. See acast.com/privacy for more information.

Amazon announces plans to acquire concierge primary care company One Medical for $3.5B. President Biden tests positive for COVID and is reporting mild symptoms. And health systems are feeling the pain of at least 18 drugmakers' restrictions on 340B discounts to contract pharmacies. Hosted on Acast. See acast.com/privacy for more information.

On this episode of Gist Healthcare Daily, Apple lays out its health strategy. Health costs and inflation are driving premium increases for individual market plans. And the story of how one health plan addressed racial disparities in medication adherence. Hosted on Acast. See acast.com/privacy for more information.

Morgan Health announces its next investment, $30M in Centivo. Even with a vaccine, experts believe we missed the opportunity to contain Monkeypox. And as Kaiser Health News reports, California’s special Medicaid contract with Kaiser Permanente is now official, though several details are missing. Hosted on Acast. See acast.com/privacy for more information.

On today's episiode, Medicare proposes a pay bump for hospital outpatient services, but the American Hospital Association says it’s not enough. The nation's top infectious disease official Dr. Anthony Fauci says he plans to retire by the end of Biden’s first term. And amid a rise in antibiotic-resistant infections, companies aren’t investing in new antibiotics. Hosted on Acast. See acast.com/privacy for more information.

In this episode, Will Schpero, Ph.D., a health economist, and assistant professor in the Division of Health Policy and Economics at Weill Cornell Medical College discusses how the new requirement for Medicaid programs to cover the routine costs of clinical trials presents an opportunity to greatly improve diverse patient representation in cutting-edge clinical research. Hosted on Acast. See acast.com/privacy for more information.