Business Intelligence

Providers utilize business intelligence to monitor referral patterns and collaborate with clinicians who order their services. Such analytics tools have also been deployed in the specialty to improve productivity, track patient satisfaction and bolster quality.

DOJ accuses nonprofit nursing homes of providing ‘grossly substandard’ care

Four nursing homes operated by ProMedica Health System are alleged to have failed to adequately feed patients, treat wounds and keep patients clean. The DOJ said the facilities falsified records to cover their tracks.

CVS Health announces $10.6B acquisition of Oak Street Health

Massachusetts settles $12M lawsuit against CVS over alleged drug overpricing

The pharmacy chain also agreed to perform an annual audit of billed drug prices to ensure it does not run afoul of the state’s “Most Favored Nation” policy. 

chatgpt artificial intelligence healthcare

Healthcare AI today: Bad diet advice from LLMs, ‘Dawn’ working on cancer vaccine, Generative AI earns $50M, OpenAI’s healthcare push

OpenAI, the developer of ChatGPT, has made a couple of big hires as it prepares for a major expansion into healthcare.

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Report: DOJ investigating business practices of UnitedHealth’s Optum Rx

Bloomberg said the pharmacy benefit manager is being probed as part of a larger look into the “prescription management services” of UnitedHealth. According to sources, this may be related to an ongoing investigation into alleged instances of Medicare Advantage upcoding.

Drugs money scam

New $6B Eversana looks to bypass PBMs and lower drug prices

A merger between Eversana and Waltz Health will create a new entity that CEO Mark Thierer says will upend the “existing oligopoly that I helped build.”

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Dispute between Johns Hopkins and UnitedHealthcare pushes patients out-of-network

The two said they’ve been negotiating terms for eight months. Sticking points include denied claims and coverage disputes, with both the insurer and health system pointing fingers.

Blue Cross Blue Shield BCBS

Court approves $2.8B BCBS class-action settlement; insurer to make changes

The settlement reached in October 2024 has been finalized. A fund is being set up for the estimated 3 million claimants, as BCBS pledges to reform its BlueCard health plans.

Ransomware attack on DaVita kidney care clinics exposes 2.7M patients

The initial incident happened in April. Since that time, the notorious cybercrime cell Interlock has claimed responsibility. A data dump from the breach was put up for sale on the dark web.