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Pediatric ER utilization algorithm hurts Black and Hispanic patients, study finds
A diagnosis claims-based algorithm used by payers to decide whether pediatric patients need to be taken to the emergency department has been promoted as a way to cut healthcare costs. But according to a new JAMA Network Open study, this algorithm will …
Health systems pledge to make 10% of new hires from disadvantaged communities
Seventeen health systems, including Cleveland Clinic and Advocate Health, have pledged a commitment to make 10% of all new hires “impact hires” – meaning employees hired from economically disadvantaged areas.
Most employers intend to keep preventive services even after Texas ACA ruling
At the tail end of March, a ruling by a federal judge in Texas invalidated much of the Affordable Care Act’s coverage of preventive care without cost sharing, but a new survey from the National Alliance of Healthcare Purchaser Coalitions showed that ab…
Oscar Health exiting California’s ACA exchange next year
Insurtech Oscar Health signaled during an earnings call on Tuesday that it will be exiting California’s individual market beginning next year, with CEO Mark Bertolini saying the plan has fallen short of the company’s goals.
Optum’s 25% revenue growth fuels UnitedHealth Group’s Q1 earnings
Thanks in part to a 25% increase in revenue for Optum, UnitedHealth Group saw $5.6 billion in earnings during the first quarter of the year, and $91.3 billion in revenue, both far and above other major insurers, according to the company’s financial res…
Medicaid work requirements may result in 1.7M in coverage losses
At the tail end of April, Republicans in the House of Representatives passed a debt ceiling bill that includes a stipulation for states to implement work requirements for certain Medicaid enrollees.
Premier considering moves to increase value, including possible sale
Tech-driven healthcare company Premier is considering a number of potential strategic alternatives to enhance the value of the company for stakeholders, including the sale of all or part of the company, according to an announcement this week.
HCA Healthcare investing $300M in nurses’ training, education
HCA Healthcare has said it’s pledging more than $300 million in investments to support the education and training of nurses. This includes more than $200 million towards the expansion of Galen College of Nursing and approximately $136 million towards t…
Humana, Longevity Health partner on Medicare special needs plans
Health insurer Humana and Longevity Health Plan have joined forces to expand special needs health plan offerings that support the requirements of Medicare-eligible patients living in skilled nursing and senior living facilities.
The two companies have …
OIG finds $580 million in improper psychotherapy Medicare payments
The popularity and utility of telehealth has made it a more common form of healthcare delivery since the start of the COVID-19 pandemic, and telepsychiatry is one of the most used applications for the remote care technology.
