The Gist Healthcare Podcast

The Biden Administration proposes a rule that could make dental care covered under Affordable Care Act plans.Hospitals and health system executives say investing in cyber security is their top investment priority for their 2024 IT budgets. And, a new survey finds that nearly half of American adults faced healthcare billing issues within the last year. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Employee healthcare navigation company Transcarent announced in September that it has partnered with an inaugural group of 10 large health systems to create what it calls a national, independent “provider ecosystem” in order to  provide higher-quality care to the covered beneficiaries of its more than 300 employer clients. On today’s episode of Gist Healthcare Daily, Transcarent CEO Glen Tullman joins the show to talk more about the health system partnerships and the company’s direct contracting model. Hosted on Acast. See acast.com/privacy for more information.

The American Medical Association releases its latest policy focuses…including pushing for diabetes drugs to be covered for weight loss. Medicare will cover navigation services for cancer patients under a new rule, And, around 36 million adults in the US have received the updated COVID shot. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

UnitedHealth faces a lawsuit over its use of an algorithm in its Medicare Advantage denials. State Medicaid administrators anticipate a steep drop in enrollment and more spending on the program from state governments in 2024.  And, the Biden Administration issues its final rule requiring nursing homes to be more transparent with their ownership information. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Amazon’s One Medical inks more partnerships with health systems across the country. New York lawmakers propose tighter cybersecurity restrictions for hospitals. And, life expectancy for men in the US drops to 73 years--six years less than women--according to a new study. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Health systems sue the Health Resources and Services Administration over its recent reversal of its 340B off-site clinic registration policy. Pharmacy benefit managers would face tighter restrictions under a new Senate bill. And, private equity firm Thoma Bravo finalizes its acquisition of electronic health records vendor NextGen. That’s coming up 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, Brad Kittredge, founder and CEO of digital mental healthcare provider platform Brightside Health, joins to talk more about the services Brightside provides. He also discusses the organization’s recent announcement that it will expand access to Medicaid and Medicare populations through its partnerships with health insurers. Hosted on Acast. See acast.com/privacy for more information.

Kaiser Permanente healthcare workers approve a new four-year contract a month after their historic, large-scale strike. Amazon offers a reduced membership price to One Medical for its Prime subscribers. And, the Food and Drug Administration approves Eli Lilly’s GLP-1 drug–tirzapetide–for chronic weight management. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Hospitals and health systems across the country have seen an alarming increase in both the frequency and severity of workplace violence incidents. Toni Ardabell, Chief of Clinical Enterprise Operations for Inova Health System in Falls Church, Virginia joins Gist Healthcare Daily to talk more about how Inova has created a  multidisciplinary team to better address the issue and create a safer environment for staff and patients.  This episode originally aired on July 31, 2023 Hosted on Acast. See acast.com/privacy for more information.

The Biden Administration proposes stricter marketing rules for Medicare Advantage plans. North Carolina’s Attorney General threatens to sue for-profit health system HCA for violating its Mission Health purchasing agreement. And, the rate of hospital-acquired infections has dropped after a surge during the pandemic. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

CMS issues its final Medicare reimbursement rules for 2024, with outpatient facilities seeing a pay bump and physicians facing payment cuts. The American Hospital Association challenges the Department of Health and Human Services over its third-party web tracking rule in a new lawsuit. And, a new Minnesota law requires hospitals in the state to inform patients of financial assistance before collecting medical debt. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

For months, federal lawmakers in Washington D.C. have been at odds over reauthorizing the United States President's Emergency Plan For AIDS Relief–better known as PEPFAR–a U.S. initiative to address the global HIV/AIDS epidemic. The program has largely had bipartisan support on the Hill since it was first introduced in 2003 under then-President George W. Bush's administration. However, in recent months, its reauthorization has been held up by Republicans who allege the funding is being used to pay for abortions overseas, a claim PEPFAR administrators have denied. On today’s episode of Gist HealthcareDaily, Washington Post national health reporter Dan Diamond joins to talk more about the current fight on Capitol Hill and how it recently came to light that $1 billion in federal funds are being withheld from the program by Republican lawmakers. Here’s some of Dan’s recent reporting on the issue:Republicans delay more than $1 billion in HIV program funding (Published: October 26, 2023)Lifesaving HIV program faces a new threat: U.S. abortion politics (Published: July 29, 2023)  Hosted on Acast. See acast.com/privacy for more information.

Walmart strikes a deal with Orlando Health, its first health system partnership. CMS backtracks on proposed home health Medicare payment cuts. And, infant mortality in the United States rose for the first time in two decades, according to a new report. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Health tech unicorn Olive AI winds down its operations and sells its assets. Ransomware attacks on healthcare organizations have cost the U-S economy more than $77 billion in downtime alone. And, new analysis from the Lown Institute finds that nearly a quarter of hospital stent procedures are unnecessary and drive up costs. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The Department of Health and Human Services is proposing new penalties for providers that engage in information blocking. A new executive order from President Biden zeroes in on artificial intelligence, particularly in healthcare. And, pharmacists and workers at the nation’s largest pharmacy retail chains go on strike. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The Department of Health and Human Services reverses its COVID-era 340B off-site clinic policy. The Biden Administration proposes an overhaul of the No Surprises Act’s independent dispute resolution process. And, the federal government will stop covering COVID drugs this week. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

At this year’s HLTH conference in Las Vegas, Nevada, JC sat down with Sachin Jain, MD, CEO of SCAN Health Plan, a not-for-profit provider of Medicare Advantage plans based in Long Beach, California. They discuss SCAN’s planned merger with Care Oregon and broader competition in the MA market as well as the growing tension between providers and MA plans. Hosted on Acast. See acast.com/privacy for more information.

Walmart expands a pilot benefit program that provides doula care for postpartum employees nationwide. CVS pulls some decongestants from shelves that were recently found to be ineffective. And, a new survey finds that healthcare is still unaffordable, even for those with insurance. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The CDC recommends rationing a RSV shot for babies due to shortages. The Senate HELP committee advances President Biden’s National Institutes of Health nominee, Dr. Monica Bertagnolli. And, a new survey finds that the number of healthcare workers experiencing workplace harassment doubled in 2022, and is negatively impacting their mental health. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Henry Ford Health and Ascension Michigan enter into a $10.5 billion joint venture. National vitamin and supplement retailer GNC gets into virtual telehealth. And, Georgia’s Medicaid work requirement expansion sees slow enrollment during its first quarter. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Blue Cross Blue Shield of North Carolina moves to buy FastMed urgent care centers in the state. More than nine million people have been removed from state Medicaid rolls six months into the redetermination process. And, new analysis looks at how many rural hospitals have switched to the new Rural Emergency Hospital designation. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Congressional committees have weighed legislation over the past months that would further regulate pharmacy benefit managers, if passed. But these bills may not have a significant impact on drug spending, and could even have the opposite of their intended effects, according to new analysis from the Brookings Institution. On today’s episode of Gist Healthcare Daily, Matthew Fiedler, Joseph A. Pechman Senior Fellow in Economic Studies at the Brookings Institution and senior fellow with the Brookings Schaeffer Initiative on Health Policy, joins to talk more about what he and his team found. Hosted on Acast. See acast.com/privacy for more information.

Walgreens and startup health insurer Alignment Health partner on Medicare Advantage plans for 2024. Amazon’s One Medical quietly rebrands its Iora Health senior care clinics. And, new analysis finds that family premiums rose an average of 7% for employer-sponsored health coverage this year. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

CMS has removed amyloid PET scan restrictions for Medicare beneficiaries. Novo Nordisk stops its Ozempic trial for treating kidney failure following early signs of the drug’s success. And, a new study finds that healthcare providers continue to leave the field in droves. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Hundreds of physicians at Allina Health vote to unionize. California raises the minimum wage for healthcare workers. And, Walgreens moves to close 60 VillageMD locations in an effort to cut costs. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Kaiser Permanente and the unions representing its healthcare workers who recently went on strike reach a tentative new contract agreement. National retail pharmacy chain Rite-Aid files for bankruptcy. And, the number of Medicare Advantage plans rated four stars or more drops for the 2024 plan year. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

In early October, Providence Health unveiled Praia Health, its fourth, incubated technology. Praia utilizes what the Digital Innovation Group calls a digital flywheel to keep patients engaged with their care by personalizing individuals' health journeys and seamlessly connecting them to the right services, products and resources. On today’s episode, we hear the second half of JC’s conversation with Sara Vaezy, Executive Vice President and Chief Strategy and Digital Officer for Providence, where they talk more about Praia’s value proposition to hospitals and the future of the health system’s digital strategy. You can listen to the first part of our conversation here. Hosted on Acast. See acast.com/privacy for more information.

UnityPoint Health and Presbyterian Healthcare Services call off their proposed merger. California is one step closer to establishing universal health coverage for residents. And, AmSurg will officially split from parent company Envision, amid Envision’s bankruptcy restructuring. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Walgreens names former Cigna executive Tim Wentworth as its next CEO following the departure of its former chief executive Roz Brewer last month. And, some final updates from HLTH, including Walmart’s decision to expand its virtual primary care pilot to all of its employees and their families. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

An estimated 10,000 people descended on Las Vegas this week to attend HLTH23, a three-day conference that brings together healthcare stakeholders from around the world. The conference reflects some of the biggest changes happening in health and tech, including this year’s star: artificial intelligence. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The fifth annual HLTH conference is currently underway in Las Vegas. Since it began in 2018, HLTH has become one of the premier healthcare and networking conferences in the country, bringing together healthcare stakeholders from the United States and across the globe. On today's episode of Gist Healthcare Daily, we have updates from the first two days of the conference, as well as some healthcare news updates from outside of HLTH. Hosted on Acast. See acast.com/privacy for more information.

Renton, Washington-based health system Providence recently unveiled Praia Health, its latest incubated technology. Praia is a platform-as-a-service developed for health systems to increase patient engagement by personalizing individuals' health journeys and seamlessly connecting them to the right services, products and resources. On today’s episode of Gist Healthcare Daily, Sara Vaezy, Executive Vice President and Chief Strategy and Digital Officer for Providence, joins to talk more about Praia Health, including its goals and the issues it aims to address.  Hosted on Acast. See acast.com/privacy for more information.

Minnesota’s Attorney General further scrutinizes two proposed cross-state health system mergers. Moderna’s combination flu and COVID vaccine advances to Phase 3 clinical trials. And, providers could face Medicare payment penalties under tougher quality program standards starting next year. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Tens of thousands of Kaiser healthcare workers go on strike across several states. Progressive lawmakers call for greater scrutiny of UnitedHealth's pending acquisition of home care group Amedisys. And, Instacart partners with health insurance startup Alignment Health on co-branded Medicare Advantage plans. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Public health programs and safety net hospitals will continue to get federal funding - at least temporarily. Drug makers agree to negotiate drug prices with Medicare, even as they continue their legal fight over the process. And, parents and caregivers across the country struggle to get COVID vaccines for children. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

More than 75,000 Kaiser healthcare workers are set to strike across several states this week as their current employment contract expires. Cigna will pay $172 million to settle its Medicare Advantage fraud suit. And, a new report finds that the Center for Medicare and Medicaid Innovation has raised federal spending, not lowered it. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

An estimated $100 billion in care is delivered every year in the infusion therapy market, and it’s expected to continue growing. Today, Uptiv Health CEO and co-founder Torben Nielsen joins the podcast to talk more about how Uptiv is trying to change the model for infusion care by  providing hybrid, whole-person care in partnership with specialists and hospitals. Hosted on Acast. See acast.com/privacy for more information.

Numerous hospitals and health systems have recently had their credit rating downgraded. The Biden Administration says insurance issues for the updated COVID vaccines have been largely resolved. And, Elevance and Blue Cross Blue Shield of Louisiana hit pause on their proposed merger. That’s coming up on today’s episode of Gist Healthcare Daily.You can find the Kaufman Hall blog post referenced in the credit ratings story here. Hosted on Acast. See acast.com/privacy for more information.

A new report finds that safety net care providers bought nearly $54 billion of 340B discounted drugs last year. The Biden Administration wants to remove medical debt from consumer credit reports. And, Cano Health sells its Nevada and Texas primary care clinics to Humana. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

North Carolina will expand Medicaid before the end of the year…following a long budget approval process. President Biden signs a measure to overhaul the nation’s organ transplant system. And, employee healthcare navigation company Transcarent announces the launch of a new national provider network of 10 large nonprofit health systems. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

More than 75,000 Kaiser workers sign on to a three-day strike as negotiations falter. The Centers for Disease Control and Prevention recommends the RSV vaccine for pregnant people. And, Costco is the latest major retailer getting into healthcare delivery. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The Centers for Medicare and Medicaid Services unveiled proposed rule changes in July that would require price data to be standardized across hospitals. On today’s episode, Turquoise Health CEO Chris Severn joins the podcast to talk more about the proposed rule and the state of healthcare price transparency in the market today. Hosted on Acast. See acast.com/privacy for more information.

The Biden Administration announces it will again send free COVID tests to US households. CMS says parts of the No Surprises Act dispute resolution process can resume. And, the FTC sues US Anesthesia Partners and private equity firm Welsh Carson, alleging they formed a monopoly to drive up prices for services in Texas. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

A hospital price transparency bill is pulled from the House floor. A recent ‘secret shopper’ study finds discrepancies between hospital prices quoted online versus over the phone. And, Bright Health reaches a risk-adjustment shortfall agreement with the federal government. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

New analysis finds that more than 80% of nursing homes currently fall short of staffing levels being proposed by CMS. An FDA panel finds that the active ingredient in many over-the-counter decongestants is ineffective. And, Oracle announces it will add generative AI to its EHRs to help physicians reduce their workload. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Sixty-seven thousand Kaiser Permanente workers vote to authorize a strike. Dana-Farber and Beth Israel Deaconess partner on a new cancer center. And, Oregon approves a plan to create a new basic health plan for residents who earn too much to qualify for Medicaid. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The hospital-at-home care model is expected to expand significantly by the end of the decade, but questions remain about who will pay for it and how. On today’s episode of Gist Healthcare Daily, we hear the second part of our conversation with Rob Moskowitz, MD, Chief Medical Officer at Contessa Health, where we discuss the outlook for reimbursement as well as thoughts on the clinical staff needed to deliver the model at scale.  You can listen to the first part of our conversation here. Hosted on Acast. See acast.com/privacy for more information.

A looming government shutdown could impact crucial healthcare programs. A new study conducted by the Blue Cross Blue Shield Association is the latest to find that outpatient care at hospitals is more expensive compared to surgery centers or physician’s offices. And, most ambulance rides are out of network, according to a new report. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

California healthcare workers could see a pay raise under a new deal. The newest COVID vaccines will be available this week, but for the first time without the federal government guaranteeing they’ll be free. And, prescription opioid shipments dropped as fatal overdoses increased. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The FDA approves updated COVID vaccines amid a summer surge. Walgreens partners with provider enablement company Pearl Health to grow its value-based primary care business. And, Geisinger and Best Buy expand their at-home chronic disease management partnership. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.