The Health Colossus

AMA and ISMS File Antitrust Lawsuit to Break MultiPlan Price-Fixing Cartel - Chicago, USA The American Medical Association (AMA) and Illinois State Medical Society (ISMS) have filed a federal lawsuit against cost-management firm MultiPlan, alleging the company is orchestrating an extensive price-fixing scheme to suppress physician reimbursement rates for out-of-network care. Filed Thursday in the U.S. District Courts for the Northern District of Illinois, the lawsuit contends that MultiPlan has been working with major health insurers since at least 2015 to drive down payments to healthcare providers, often below operating costs, which has forced many practices to limit services or close entirely. Read more at, https://lnkd.in/diZ5kMWJ | The Health Colossus #healthcare #healthlaw #lawsuit #usa #news #thehealthcolossus

Cleveland Clinic and Amazon One Medical to Collaborate on Primary Care Clinics in Northeast Ohio, USA In an innovative partnership, Cleveland Clinic and Amazon One Medical have announced plans to open primary care offices across Northeast Ohio. The first office, affiliated with the Cleveland Clinic, is expected to launch next year, offering patients same-day and next-day appointments, along with onsite lab services and virtual care support. Amazon One Medical, a hybrid primary care provider that offers both in-person and virtual care, will manage the offices, ensuring adequate time between appointments to foster meaningful patient-provider interactions. The partnership will also leverage Cleveland Clinic’s extensive network of specialists, hospitals, and healthcare facilities, providing patients with broader access to expert care. Through the Amazon One Medical mobile app, members will benefit from virtual services like on-demand video visits, secure messaging with providers, digital assessments for common health concerns, and access to vaccination records, medical prescriptions, and proactive follow-up care reminders. These features aim to streamline patient care and improve health outcomes. Amazon One Medical currently partners with more than 10,000 employers across the U.S., offering membership-based healthcare as an employee benefit. The collaboration with Cleveland Clinic is expected to enhance primary care access in the region, while supporting Cleveland Clinic’s mission to deliver top-quality healthcare. “This collaboration demonstrates a shared commitment from both organizations to meet the needs of our patients and enhance the care we provide to our communities,” said Dr. Tomislav Mihaljevic, M.D., CEO and president of Cleveland Clinic. “Amazon One Medical will complement our current primary care offerings, enabling patient access to essential health services.” As the partnership evolves, Cleveland Clinic and Amazon One Medical will strategically determine the locations of additional clinics over the coming years, further extending their reach and impact across Northeast Ohio. https://lnkd.in/dnjnnrby | The Health Colossus #healthcare #partnership #primaryhealthcare #clinics #ohio #usa #health #news #thehealthcolossus

Sanford Health and Marshfield Clinic Health System Finalize $10 Billion Merger Sanford Health and Marshfield Clinic Health System officially signed a $10 billion merger agreement, according to a joint announcement made on Wednesday. The agreement follows their initial disclosure of merger plans in July. The two health systems said the merger would enhance access to high-quality care for residents in the rural Midwest. Upon completion, the combined entity is expected to generate approximately $10 billion in annual revenue. Sanford Health, the largest rural health system in the U.S., operates 45 hospitals, 211 clinics, and over 160 senior living centers. Headquartered in Sioux Falls, South Dakota, Sanford employs 2,900 physicians and advanced practice providers. Marshfield Clinic Health System, based in Wisconsin, oversees 60 clinics, 11 hospitals, and a children's hospital, with a workforce of more than 1,700 providers. Both systems also manage their own health plans, which together would serve over 425,000 members once the merger is finalized. Read more at, https://lnkd.in/dASnArpy | The Health Colossus #healthcare #mergers #acquisitions #sanfordhealth #marshfieldclinichealthsystem #usa #health #news #thehealthcolossus

Atropos Health Unveils Chat-Based AI Co-Pilot for Real-World Evidence at HLTH24 Atropos Health, a leading innovator in real-world data platforms, has officially launched its cutting-edge AI solution, ChatRWD, after a successful beta program. This generative AI tool is designed to help clinicians and researchers generate high-quality, publication-grade real-world evidence in minutes—reducing the process from months to mere moments. According to the company, this innovation cuts down the time it takes to create observational studies, providing answers in minutes using a chat-based interface. Unlike other widely recognized large language models (LLMs) like ChatGPT and Google Gemini , ChatRWD is specifically built to address clinical questions more accurately, thanks to its access to Atropos Health's extensive evidence network, which contains over 300 million anonymous patient records. The AI’s accuracy is further validated by its "real world fitness score" (RWFS), an indicator of the quality of data used to generate answers. The average RWFS score of 79.8 from the beta program highlights the high reliability of the platform. Clinicians and researchers are now invited to register for access to ChatRWD, which is positioned to play a pivotal role in the rapidly evolving fields of real-world evidence research and artificial intelligence. Neil Sanghavi, president of Atropos Health, highlighted the importance of high-quality clinical evidence amid the rapid advancement of AI in healthcare. "ChatRWD’s performance exceeded our expectations, both technically and in terms of user satisfaction, which brings us to this exciting launch," he said. Read more at, https://lnkd.in/dQQYixMi | The Health Colossus #healthtech #ai #ml #digitaltech #news #thehealthcolossus

Cigna-Humana Merger Talks Resurface: Early Discussions in Progress The Cigna Group has reportedly revived merger discussions with Humana, according to a recent Bloomberg report. Sources familiar with the matter have indicated that informal talks have resumed, though they remain in the early stages. Before pursuing any merger, Cigna is focused on completing the sale of its Medicare Advantage business, which is seen as a key step in simplifying the transaction. While talks are ongoing, the companies have yet to reach any formal agreement, and there is a possibility they may decide against a deal or push discussions into the new year. Following the news, Humana's stock saw an uptick, while Cigna's shares dropped by about 5%, reflecting mixed investor sentiment. Despite this, the divestiture of Cigna’s Medicare division could ease regulatory concerns, potentially paving the way for a smoother merger process, especially in relation to Humana's Medicare Advantage business. Stay tuned for further updates as the situation develops. | The Cigna Group https://lnkd.in/dg8QX2Ev | The Health Colossus #healthcare #business #economy #mergers #acquisition #cigna #humana #thehealthcolossus

Google Cloud Unveils Generative AI Tools to Ease Healthcare Workers' Burden Medical information, notorious for its complex vocabulary and abbreviations, has long been difficult to search effectively. Google Cloud is addressing this challenge with its new generative AI tools, specifically designed to streamline the process for healthcare professionals. Google Cloud executives announced that their Vertex AI Search for Healthcare platform is now generally available, along with new features for the Healthcare Data Engine. The Vertex AI Search for Healthcare tool promises to expedite how healthcare employees retrieve crucial data from medical records and clinical documents. By leveraging medically trained generative AI, it can search across diverse datasets, including FHIR (Fast Healthcare Interoperability Resources) data and clinical notes. The tool interprets complex medical nuances, such as abbreviations and specialized terminology, in a single, intelligent search. Moreover, Vertex AI Search integrates with Google Gemini 1.5 Flash and MedLM, its medical large language model, to provide more accurate and digestible responses based on patient records. By using an organization’s own data as a foundation, this tool aims to reduce errors and inaccuracies—commonly referred to as hallucinations in AI models—by linking users directly to internal, verifiable sources of information. One prominent integration is with Meditech’s Expanse EHR system. "We’re providing clinicians with an intuitive and efficient way to access the precise information they need, when they need it," said Helen Waters, MEDITECH's Executive Vice President and Chief Operating Officer. According to Waters, this integration not only reduces administrative workload but also supports better clinical decision-making, ultimately leading to improved patient outcomes. For instance, Meditech’s client, Mile Bluff Medical Center, has reported saving over 7.5 minutes per patient in preparation time. In addition to Vertex AI Search, Google Cloud’s Healthcare Data Engine facilitates the creation of interoperable, longitudinal patient records in the FHIR format, further enriching clinical insights and data accessibility. These innovations represent a significant leap forward in reducing the administrative burden on healthcare workers while enhancing patient care through smarter, AI-driven solutions. Read more at, https://lnkd.in/dXVCgebE | The Health Colossus #google #healthcare #generative #ai #medlm #mlm #healthtech #health #news #thehealthcolossus

Elevance Health Stock Slides Amid Lower Earnings Forecast Elevance Health joined UnitedHealth Group, citing Centers for Medicare & Medicaid Services timing mismatches as a significant drag on earnings. For the third quarter, Elevance reported a net income of $1 billion, down 22.5% from $1.3 billion during the same period in 2023. Despite this quarterly decline, net income for the nine months ending September 30 reached $5.5 billion, up from last year's $5.1 billion. Shares of Elevance dropped 12% on Thursday after the health insurer lowered its full-year earnings forecast, according to Seeking Alpha. President and CEO Gail K. Boudreaux highlighted the challenges posed by Medicaid, specifically pointing to the timing mismatch between Medicaid reimbursement rates and patient acuity, a headwind also noted by UnitedHealth Group earlier this week. According to Seeking Alpha, Elevance faced higher-than-expected medical expenses in the third quarter, but revenue still grew, driven by higher premium yields in its Health Benefits segment and increased CarelonRx product revenue. This growth was partially offset by membership attrition in the Medicaid business. Shares of other peer insurers also saw premarket declines: Molina Healthcare (-11.18%), Centene Corporation (-8%), CVS Health (-1.68%), and Humana (-2.18%). Read more at, https://lnkd.in/dvwVHxDv | The Health Colossus #healthcare #stockmarket #investments #news #thehealthcolossus

Karen Lynch Exits CVS, David Joyner Appointed President and CEO In significant leadership news, Karen S. Lynch has stepped down from her role as President and CEO of CVS Health, with David Joyner taking her place. This shift marks a notable transition in the company’s leadership, as CVS navigates its future direction under new guidance. Medicaid Timing Mismatch Cited as a Headwind by UnitedHealth Group and Elevance Health Both UnitedHealth and Elevance Health have pointed to the Centers for Medicare & Medicaid Services timing mismatch as a key challenge impacting their earnings. Elevance, in particular, reported a third-quarter net income of $1 billion, a 22.5% decrease compared to the $1.3 billion in the same period of 2023. Despite this decline, the company’s net income for the nine months ending September 30 reached $5.5 billion, a slight increase from last year's $5.1 billion. Shares of Elevance Health fell 12% on Thursday after the health insurer adjusted its full-year earnings forecast, according to Seeking Alpha. CEO Gail Boudreaux echoed concerns voiced by UnitedHealth earlier in the week, stating that the mismatch between Medicaid rates and patient acuity has been a significant earnings drag. Shares of other peer insurers also took a hit in premarket trading, including Molina Healthcare (-11.18%), Centene Corporation (-8%), CVS Health (-1.68%), and Humana (-2.18%), Seeking Alpha reported. Earlier this week, during UnitedHealth's earnings call, CFO John Rex highlighted another issue plaguing insurers: a "pronounced upshift in coding intensity by hospitals." Some hospitals have increased their coding intensity by over 20%, contributing to rising costs in the healthcare system. Rex also pointed out a rapid rise in the prescribing of high-cost specialty medications for cardiovascular diseases, autoimmune disorders, and cancer. The Inflation Reduction Act, which eliminated the individual coinsurance requirement during the catastrophic coverage phase, may have accelerated this trend, Rex suggested. Read more at, https://lnkd.in/genN5TRK | The Health Colossus #healthcare #market #cap #sharemarket #stocks #pharma #news #usa #thehealthcolossus

Department of Health – Abu Dhabi Unveils Sahatna Unified Healthcare App at GITEX Global 2024 The Department of Health Abu Dhabi, the healthcare sector regulator for the emirate, has officially launched Sahatna, a comprehensive mobile app that empowers residents to manage their health effortlessly. Offering a wide array of health and wellness services, the app allows users to book appointments, engage in teleconsultations, access health records, and receive genomic reports—all from the convenience of their smartphones. Unveiled at GITEX Global 2024 - Dubai, the world's largest technology exhibition in Dubai, this innovative app aims to transform patient experiences across Abu Dhabi. Sahatna is set to drive emirate-wide behavioral changes, contributing to long-term improvements in health outcomes and fostering a healthier future for all residents. Sahatna was developed in partnership with Abu Dhabi Health Data Services (ADHDS), operator of Malaffi, to deliver innovative digital health solutions. Kareem Shahin, CEO of ADHDS, highlighted the collaboration's transformative potential, stating, “Our partnership with the DoH for Sahatna is a significant step toward a healthier, more connected future. This collaboration will not only enhance access to quality healthcare but also empower individuals to lead vibrant and fulfilling lives.” Ibrahim AlJallaf, Executive Director of Digital Health at DoH, added that over 60% of healthcare facilities in Abu Dhabi are already connected to Sahatna. “This is just the beginning. We are developing a roadmap filled with advanced features tailored to individual needs, making healthcare more efficient and personalized than ever before.” He emphasized upcoming enhancements, including expanded access to primary care services and an AI-powered patient assistant. Visitors to Abu Dhabi can also benefit from Sahatna, which provides information on nearby healthcare facilities and available services, along with options for both in-person and remote consultations. Read more at, https://lnkd.in/dWPyJ_mE | The Health Colossus | Abu Dhabi Media Office | GITEX GLOBAL Largest Tech & Startup Show in the World #healthcare #technology #application #publichealth #abudhabi #uae #healthnews #thehealthcolossus

Colorado Provider Axis Health System Hit by Cyber Incident - $1.6 Million Ransom Colorado-based Axis Health System, which provides primary care, dental services, and mental healthcare, has been hit by a significant cyber incident. The healthcare provider posted a notice on its website, stating that an investigation into the situation is underway. As a result of the attack, Axis’ primary care patient portal is currently offline. The provider has assured that patients will be informed via mail if their personal data has been compromised. According to Dubai-based cybersecurity firm Hackmanac, the ransomware group Rhysida has claimed responsibility for the incident. Rhysida, which has previously targeted healthcare organizations, is reportedly demanding a ransom of nearly $1.6 million. Read more at, https://lnkd.in/dMt2Rs5p | The Health Colossus #healthcare #cyberattacks #healthtech #healthindustrty #news #thehealthcolossus