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.

Florida probes CVS Health in latest crackdown on PBMs
State Attorney General James Uthmeier is forcing the company to hand over thousands of documents related to its pharmacy contracts and reimbursement policies to see if the retail giant is abusing its position in the market as both a pharmacy benefit manager and a retail chain of drug stores.
Private equity unlikely to dominate cardiology despite hype
Medaxiom CEO Jerry Blackwell, MD, MBA, FACC, discusses investor's interest in buying cardiology practices, noting that PE ownership remains relatively low.
OIG warns of ‘ghost network’ trouble in maternal health managed care
Looking at the three largest Medicaid managed care plans related to maternal health, the Office of Inspector General found instances of ineligible providers being included in directories, as well as other errors such as incorrect contact information.
OhioHealth agrees to void contracts that allegedly punished payers for including competitors in-network
The U.S. Department of Justice said the settlement will save citizens of the state money and open up the market to competition.
Major private payer encouraging employees to leave willingly
The largest Medicaid-specialized managed care organization in the U.S. is offering buyout packages to most of its 60,000 or so staff workers.

CVS Health announces $10.6B acquisition of Oak Street Health

DOJ sues CVS over unlawful opioid prescriptions and reimbursement

The U.S. Department of Justice said policies at CVS Health forbade pharmacists from discussing patients and providers who may be prescribing opiates in violation of the Controlled Substance Act.

artificial intelligence AI in healthcare

Industry Watcher’s Digest

Nurses are making their peace with workplace AI.

Data breach at chain of clinics impacts 450K patients

The Center for Vein Restoration has notified patients about a data breach that occurred in October, exposing financial and medical information on patients from across the U.S.

Mangione charged with terrorism-related murder in UnitedHealthcare CEO killing

A grand jury in New York has indicted Luigi Mangione, 26, on 11 charges, including murder in the first degree.

Industry Watcher’s Digest

Will the second Trump Administration manage AI’s risks—or ‘unshackle’ AI’s potential?

artificial intelligence AI healthcare regulation FDA

Healthcare AI regulation needs nuance, balance: Research review

When regulating AI-equipped medical devices, the FDA might take a page from the Department of Transportation’s playbook for overseeing AI-equipped vehicles. These run the gamut from assisting human drivers to fully taking the wheel.

Christmas ransomware exposed over 300K patient records to dark web

Last Christmas, Anna Jaques Hospital in Massachusetts suffered a ransomware attack. Now, nearly a year later, it confirms hackers stole personal information on 316,342 patients.

FTC warns 21 health insurance brokers against deceptive tactics

The Federal Trade Commission did not accuse the companies of wrongdoing. However, it advised them to stay out of trouble by not deploying robocalls, impersonating the government or other common illegal marketing strategies.

Business Intelligence

Florida probes CVS Health in latest crackdown on PBMs

Private equity unlikely to dominate cardiology despite hype

OIG warns of ‘ghost network’ trouble in maternal health managed care

OhioHealth agrees to void contracts that allegedly punished payers for including competitors in-network

Major private payer encouraging employees to leave willingly