December 15, 2022
13 min read
This Week in Health Tech
Table of Contents
Maverick's Highlights 💡
TWO BIG EVENTS: JP Morgan and CTA’s Consumer Electronics Show have plenty of digital health and life sciences announcements
- Enrollment in all the federal programs and the ACA marketplaces is eye-popping
HHS announced key dates for the Medicare Drug Price Negotiation Program
A Sheppard Mullin lawyer wrote a post about MA RADV audits that’s worth reading
About health IT:
- The new 2023 Interop Standards are out
- Physicians are complaining about how patients are getting scary lab test results before they are able to discuss them because of information blocking mandates
- More than 20 healthcare organizations (like UPMC and CVS) launched Health Third Party Trust (Health3PT) to address cybersecurity issues with 3rd party risk management
Three more interesting notes:
- Adam Boehler and Aneesh Chopra co-authored a Health Affairs blog post urging CMS to use digital technologies to modernize its risk adjustment methodology to improve payment accuracy.
- The FTC is proposing a rule to eliminate non-competes — major implications for the health industry
- We also noticed there were several investments in nutrition-related, SDOH-focused tech platforms.
More in the newsletter! Have a great week!
- Artificial Intelligence
- Digital Health
Digital Health News
Artificial Intelligence News
- The Cleveland Clinic entered a 10-year agreement with Palantir Technologies to use their AI technology to help manage patient flow and staff scheduling.
- A 30-day trial by the American Academy of Family Physicians using Navina’s AI Assistant program found that AI reduced visit preparation time by 61%, and improved care delivery.
- In an interview with Advisory Board, Microsoft’s AI Director discussed the current use, limitations, and future development of AI.
- An article by NASDAQ details the impact of AI on health care which includes synthetic data generation, diagnostics improvement, and cost reduction by streamlining administrative tasks.
- The Center for Connected Medicine’s newest report notes a majority of organizations use AI for patient access and that the industry should expect AI to grow over the next 2 years.
Digital Health Investments
- Upstream, a primary care tech company that helps physicians participate in value-based payment models, raised $140M in a Series B funding round led by Coatue and Dragoneer.
- Vial, a platform that facilitates clinical trials through onboarding patients, capturing outcomes, and recruiting new participants, raised $67M in a funding round led by General Catalyst.
- Hopelab, an impact investor dedicated to improving access to mental health resources, invested $1.5M in five startups: Brave Health, Caraway Health, InStride, MindRight Health, and Violet.
- Lumen raised $62M in Series B funding to expand the reach of its device that can evaluate metabolism through a breathalyzer system and provide nutrition-based recommendations.
- RxDefine rebranded as Ostro and raised $45M in funding to expand its digital and telehealth platforms that explain drugs and medical devices to patients.
- Cloud Health Systems, a nutrition-oriented startup led by Instacart’s co-founder, raised $30M to offer consumers advice focused on metabolic health and obesity.
- Medical Informatics, a remote patient monitoring company, raised $17M in Series B funding.
- Interoperability and Health IT News
Interoperability and Health IT News
- HHS’s Office for Civil Rights (OCR) issued a bulletin that warned healthcare organizations about using online tracking technologies, like Google Analytics and Meta Pixel, that collect patient information without consent or a signed agreement. The Guidance explains which online functions OCR believes are covered by the HIPAA privacy rule and creates compliance steps for organizations subject to HIPAA. More here, here.
- The National Institute of Health Information Technology Acquisition and Assessment Center (NITAAC) announced it would initiate corrective action on the 10-year, $50 billion Chief Information Officer-Solutions and Partners 4 (CIO-SP4) contract for IT platforms and services. The move occurred after 119 protests were filed with the U.S. Government Accountability, and 117 were dismissed.
- In acknowledgment of World AIDS Day, the ONC expressed its commitment to health equity by facilitating HIV data interoperability.
- In an interview with HealthcareDive, ONC head Micky Tripathi shared insight on HHS’ information-blocking enforcement, highlighting the accelerated number of complaints, reassuring existing deadlines, and explaining delays in penalty regulations, investigations, and potential warnings from the Office of Inspector General (OIG).
- GE Healthcare partnered with MediView XR to integrate augmented reality technology into X-ray imaging systems, streamlining workflows and improving ergonomics.
- Cleveland Clinic partnered with the technology company, Palantir, to create a virtual command center that predicts patient supply and demand and manages workflow scheduling.
- Health IT vendor, Goodside Health, announced a new partnership with schools to offer mental health support, like screenings, teletherapy, and crisis response services for youth.
- A JAMIA study found that Privacy-Preserving Record Linkage (PPRL) technology can use de-identified tokens from EHR and claims data to increase patient matching within the National Patient-Centered Clinical Research Network (PCORnet).
Public Health Data
- In a joint statement by the Trade and Technology Council, the U.S. and EU announced their collaboration to facilitate the exchange of health information to support research, innovation, and advancements in public health.
- The new CEO of Manifest MedEx, California’s largest health data network, wrote an article about how to leverage HIEs to improve the country’s public health infrastructure.
- A New York-based FQHC partnered with technology company, Garage, to use a population health-based platform to improve care management by facilitating patient information exchange, referral management, and clinical data integration, management, and analytics.
Data Privacy and Security
- The FBI and the Cybersecurity and Infrastructure Security Agency (CISA) warned health organizations against cybersecurity attacks from the Cuba ransomware group, which target critical infrastructure organizations and sell stolen data online.
- During the 2022 HIMSS Conference, Special Agent William McDermott addressed misconceptions, outlined the incident response process, and encouraged organizations to contact the FBI to report cyberattacks.
- Following Amazon’s acquisition of One Medical, privacy experts raise concerns about the company’s ability to protect consumer health data.
- Bank Info Security reports on the rise of healthcare data breaches, warning that third-party vendors comprise nearly 50% of breaches.
- A Capterra survey found that weaker security results from having a higher number of medical devices and nearly 24% more threats to cyberattacks and patient care.
- Payers and Providers
- Price Transparency
Payers and Providers
- A new proposed rule from CMS will require plans and providers to streamline the electronic prior authorization process and allow patient data maintained by one health plan to be transferred to another health plan when individuals change health insurance carriers.
- Starting Jan. 1, 2026, payers that contract with federal programs (e.g., MA plans, QHPs, Medicaid MCOs) must build a Fast Healthcare Interoperability Resources (FHIR) application programming interface that can automate the exchange of information related to the requirements, decisions, and supporting clinical documentation necessary for each health plan’s prior authorization process.
- CMS also proposed to require payers to exchange patient data (claims and encounter data but not cost information) when a patient changes health plans with the patient’s permission — the so-called “payer to payer” rule.
- There are also five RFIs embedded in the rule on other topics, including data standards and the exchange of social determinants and behavioral health data.
- For more information, see the fact sheet on the proposed rule. Comments will be due 90 days after the formal publication of the rule.
- A U.S. district court in Texas will rule soon on the constitutionality of the ACA’s essential health benefits, which mandate nationwide coverage of preventive care services. Several major physician groups filed a friend-of-the-court brief arguing that the free preventive services should remain in place.
- Members of the U.S. Senate Finance Committee released a discussion draft on a mental health parity legislative proposal.
- The HHS Office of Inspector General’s semi-annual report to Congress included audits of nine MA plans that were overpaid a total of $72M between 2015-2017.
- UnitedHealthcare (UHC), the country’s largest insurer, lost its latest legal battle against the private equity-owned emergency medicine clinician group TeamHealth. An arbitration panel agreed that UHC owed TeamHealth $10.8 million in underpayments for 2017 – 2020 claims, the second award to TeamHealth against UHC, as the two entities battle over out-of-network fees. UHC is suing TeamHealth for refusing to join its provider networks so it can (allegedly) charge more than the typical amount for its services.
- A new Kaiser Family Foundation study shows that employers are offering fewer retiree benefits than they have in the past.
- Sachin Jain, CEO of SCAN health plan, wrote a defense of Medicare Advantage in Forbes.
- Humana will close most of its SeniorBridge home health services to focus on Medicare Advantage plans.
- The AMA, and seven other physician organizations, defended the continuation of access to no-cost preventative health services as required by the Affordable Care Act, in a case challenging the constitutionality of those requirements.
- Advocate Aurora Health and Atrium Health completed their merger deal, becoming the fifth-largest nonprofit hospital system in the country. Its 67 operating hospitals will serve an estimated 6 million patients annually.
- Updates on provider workforce issues:
- The CDC granted the Wisconsin Department of Health Services $45 million over five years to strengthen the healthcare workforce in retention, recruitment, and training.
- According to the U.S. Bureau of Labor Statistics, the healthcare industry added 45,000 jobs in November.
- The American Nurses Association asked Congress to include six bills supporting the nursing workforce in an end-of-year funding package.
- To reduce workforce burden, CVS is testing a program that allows pharmacies to enter prescription information remotely.
- A Kaiser Family Foundation (KFF) study found for-profit hospital operating margins exceeded pre-pandemic levels for most of the pandemic, including the recent Q3 of 2022.
- Aledade staff argues in a Health Affairs blog post that payers should standardize and streamline their quality measures across markets and contracts, choosing 10 or fewer measures to reduce clinician burden.
- In a recent Health Affairs article, Health Management Associates and Duke’s Center for Health Policy staff recommend three actions that CMS can take to advance value-based care:
- pursue multiyear stability with VBP models including consistent benchmarking and program rules;
- encourage large systems to transition the breadth of their care into VBP models;
- make the current fee-for-service system less attractive.
Amazon, CVS, and Walgreens are investing millions of dollars into primary care practices, according to The Wall Street Journal, as part of a push to shift the U.S. healthcare system to a value-based care model.
- Democratic governors in North Carolina and Kansas plan to expand Medicaid next year.
- Recent Robert Wood Johnson Foundation data predicts 18 million people will lose Medicaid coverage following the end of the PHE. While most individuals will transition to other coverage options, 3.8 million people are expected to lose coverage altogether.
Health Equity & SDOH
- On the first anniversary of its Overdose Prevention Strategy, HHS released new data demonstrating the expanded capacity for treating substance use and announced two new actions to increase access to naloxone.
- The Institute for Healthcare Improvement (IHI) and AMA launched Rise to Health, a cross-industry coalition with 70 initial participants, which aims to improve health equity through access, workforce, SDOH, and quality-focused initiatives. More here.
- Unite Us’ CEO and Vice President of Social Care Integration shared recent health equity initiative successes and highlighted the importance of interoperability and telehealth in SDOH efforts in an interview with Healthcare IT News.
- A Center for Connected Medicine report explains how health systems’ IT investments are largely driven by their ability to increase patients’ access to care.
- Elevance Health announced 21 of its affiliated Medicaid plans earned the full, three-year health equity accreditation from NCQA.
- Virtual Health
- The American Hospital Association asked the Drug Enforcement Administration to release information about future telehealth regulations for prescribing controlled substances.
New Launches and Partnerships
- Oura, a Finnish digital health company, launched its Oura for Business, which focuses on sleep analysis for corporations, higher education, athletics, and the military.
- Goodside Health, a school-based healthcare provider, is launching an expansion of its healthcare solutions, called SchoolMed: Mental Health.
- Carenet Health, a patient engagement company, acquired Stericycle Communication Solutions, a similar patient engagement company.
Other Telehealth News
- A recent study conducted by America’s Health Insurance Plans (AHIP) found that the majority of respondents would prefer that the government continue with the telehealth flexibilities enacted during the pandemic.
- FAIR Health’s Monthly Telehealth Regional Tracker reported no change in telehealth usage in September compared with August, noting that COVID-19 fell in its rankings on top telehealth diagnoses lists in all regions and at the national level.
- The Cleveland Clinic is beginning to bill patients up to $50 for certain messages sent by patients to providers through its MyChart patient portal. Other hospitals and clinics are expected to follow its lead.
- The Bay Pines VA Healthcare System implemented its telehealth program, TeleCritical Care, to its intensive care unit to improve care quality and help combat staffing shortages.
Home Health and Remote Patient Monitoring
- ChromiSense Medical, a wearable health technology company, received FDA 510(k) clearance for its Polso wearable device that collects and shares users’ vital signs through its mobile app.
- Data from a University of Massachusetts Memorial Health study shows that remote patient monitoring of virtual care is as effective as in-person care for the majority of patients.
- Franciscan Health is expanding its Epic-linked telemedicine offerings to increase its remote patient monitoring and provide additional tools and support to ease in-home patient comfort.
- Artificial Intelligence
- The HHS Office of Inspector General released a report reported finding that 387 “outlier” labs should be further investigated for a variety of questionable practices, (e.g., respiratory tests and pathogen panels, genetic tests, and allergy tests) at “questionably high levels” when patients presented for COVID-19 lab tests in 2020.
- The Pandemic Response Lab, is closing, according to a report by The New York Times. The company’s CEO told the NYT that the prevalence of at-home lab tests makes the lab no longer necessary. The Pandemic Response Lab was established quickly by a robotics and lab automation company, Opentrons, to process the nearly 10 million COVID lab tests needed for New Yorkers during the pandemic,
- Authorities in Beijing, the capital city of China, announced that a negative COVID test would no longer be required for admittance to many public spaces, including grocery stores, parks, and airports.
Federal Government Activity
- In the wake of Congress deciding whether the FDA should regulate lab-developed tests (LDTs), ProPublica published a scathing report alleging that prenatal screenings are operating in an unregulated “wild wild west” environment to the detriment of patients.
- Labcorp and Natera defend their prenatal screening practices in the article.
- Former FDA Commissioners Mark McLellan and Scott Gottlieb published an op-ed in STAT to urge Congress to pass the VALID Act, saying that academic medical centers’ concerns about the burden of FDA approval of lab-developed tests have been addressed by the latest proposal. This follows a similar opinion piece the former commissioners published in JAMA when the FDA reauthorization fee legislation was under consideration earlier this year.
- The owners of multiple New York-based diagnostic testing facilities were charged with healthcare fraud after submitting illegal kickback payments amounting to over $18 million.
- They were both sentenced to three years in prison for their part in the scheme.
Patient recruiters for MBM Solutions, a Florida company, were indicted by a federal grand jury for marketing genetic tests to seniors as part of a $2.9 million Medicare fraud scheme.
Other Testing News
- Ramesh “Sunny” Balwani was sentenced to 12+ years for his role in Theranos, a start-up lab he ran with Elizabeth Holmes — who is also facing several years of jail time — that was fraudulently marketing unreliable blood-testing devices. STAT News is reporting that Congress is considering including the VALID Act in its end-of-year package because, in part, it will “close the loophole” that allowed Theranos to escape FDA review of its inaccurate diagnostic device.
- BioTechne and Oxford Nanopore Technologies partnered to develop a genetic screening tool for reproductive health. Using BioTechne’s PCR and Oxford Nanopore’s DNA sequencing technology, the tool detects pathogenic variants associated with certain genetic disorders and predicts the risk of inheriting these mutations.
- Following the Clinical Diagnostic Laboratory Test (CDLT) Advisory Panel’s advice, CMS set the price for Immunovia’s IMMray PanCan-d test at $897. It is a technology that detects pancreatic cancer.
- Quest Diagnostics agreed with Premier Inc., a healthcare improvement company with connections to thousands of hospitals and providers, to allow Premier members to access Quest’s services at a discounted rate.
- GHO Capital acquired Sapio Sciences, a leading laboratory informatics company that offers Laboratory Information Management Systems (LIMS) to researchers and laboratories.
- The European Commission demanded that Illumina cancel its acquisition of Grail, a cancer test developer, citing concerns about antitrust issues.