Plus, where digital health investors may place their bets next year

This Week

Dec 10, 2022

CMS proposes certain payers implement electronic prior authorization systems by 2026


As major hospitals now bill for some patient-provider messaging, the move could usher wider adoption


Digital health VCs eye healthcare workforce, cancer care as ripe for startups in 2023


Urban: 18M could lose Medicaid coverage after COVID-19 emergency expires likely next year


Centene completes sale of Magellan Rx to Prime Therapeutics - Paige Minemyer

 

Featured

CMS proposes certain payers implement electronic prior authorization systems by 2026

CMS issued a proposal rule to implement electronic prior authorization by 2026 for Medicare Advantage, ACA and Medicaid managed care plans, replacing a 2020 rule that was withdrawn.
 

Top Stories

As major hospitals now bill for some patient-provider messaging, the move could usher wider adoption

Big-name systems like Cleveland Clinic and NorthShore have cracked the seal on charges for certain patient portal queries. Though the new policies drew swift pushback from consumers and transparency groups, a successful rollout could see more provider organizations follow their example.

Digital health VCs eye healthcare workforce, cancer care as ripe for startups in 2023

Despite the market downturn and economic pressures, the majority of investors expect digital health dollars in 2023 to be roughly on par with 2020, bringing in an estimated $15 billion to $25 billion.

Urban: 18M could lose Medicaid coverage after COVID-19 emergency expires, likely next year

A new report estimates 18 million people could lose Medicaid coverage due to eligibility redeterminations, but most will be able to transition to other coverage sources.

Centene completes sale of Magellan Rx to Prime Therapeutics

Centene elected to sell off Magellan Rx as part of its wide-ranging value-creation plan. Under this initiative, the government insurance giant is doing a review of its full portfolio.

Advocate Aurora Health, Atrium Health close megamerger, forming the nation's 5th largest nonprofit system

Advocate Aurora Health and Atrium Health have closed their megamerger, the health systems announced Friday.

Pediatricians send an SOS to rest of medical community

Some pediatricians want to remind the rest of the medical community about how they helped acute care hospitals in March 2020. They argue that they now could use some help in dealing with the tripledemic, but aren’t getting it.

Sign-ups on ACA exchanges up 18% year over year to 5.5M so far

Sign-ups for plans on the Affordable Care Act's exchanges reached 5.5 million during the first five weeks of open enrollment, according to the latest figures from CMS.

Senators to Medicare Advantage plans: Get your provider directories in order

The Senate Finance Committee released a discussion draft outlining new ways to improve mental health pay parity as part of a larger package.

Oura launches employer-focused wellness arm

The new offering from the Finnish startup, which has U.S. headquarters in San Francisco, will equip employees with the Oura Ring to reveal the quality of sleep that will be shared with users before being anonymized and aggregated before being shared with employers. Oura partners will be able to view overall trends of their workforce or student body and work with the health tech company to reveal insights and design prompts or alter systematic structure altogether in order to improve function and performance of wearers.
 
Fierce podcasts

Don't miss an episode

'Podnosis': Biosimilars' potential to curtail drug prices and what to do about rural communities' healthcare access crisis

This week on "Podnosis," we talk about how biosimilars have the opportunity to make a dent in healthcare costs. We also discuss ways to improve healthcare services in rural areas of the U.S.
 

Resources

eBook

Harness the Power of Cloud-Based Data and Analytics to Personalize Healthcare and Improve Patient Outcomes

Personalize the healthcare journey with a data-driven platform.
Webinar

Webinar: Shared Reviews for Payer/Provider Efficiency

Find out how to start saving time and cost with electronically shared reviews and take a step closer to automating authorization.
eBook

The Change Healthcare 2022 Revenue Cycle Denials Index

The Change Healthcare 2022 Revenue Cycle Denials Index provides a review of national medical claim denial trends, with strategies to help decrease denial rates.
eBook

Humanizing Revenue Cycle Management

One sentence that will be displayed in the newsletter and should be written to grab the interest of your audience to want to read more.
 

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