HIMSSCast

Providers quickly adopted virtual care during the COVID-19 pandemic.Virtual specialist care company Summus Global saw the utilization rate of its platform jump by 3.1 times between January 2020 and January 2021, with membership growing more than 1,000%. CEO and founder Julian Flannery tells Healthcare Finance News Executive Editor Susan Morse he does not see virtual use declining to pre-pandemic numbers.Spurred by the growth, seasoned players joined emerging startups in the M&A virtual care space. Oak Street Health acquired RubiconMD for $130 million;  MDLive launched a remote patient monitoring program for virtual chronic care management; and One Medical and Humana introduced their own virtual chronic care offerings. Flannery believes these acquisitions will continue.Talking points:Summus Global has raised over $40 million in the last 12 monthsSummus sells to both employers and large health systemsPatients are set up with consultations within a network of more than 4,000 specialists across 48 hospitalsOver 80% of consumers say they will use virtual care, post COVID-19Over 75% of doctors say they will continue to use virtual careThe U.S. physician shortage will play a role in the growth of virtual visitsVirtual care is evolving rapidly to more tailored careMore about this episode:The COVID-19 crisis has 'forced people into virtual mediums,' says CEORPM startup Athelas raises $132M and more digital health fundingsOak Street Health invests only in value-based careOak Street Health buys virtual specialty care company RubiconMD for up to $190M

In January, President Joe Biden announced plans to reignite the Cancer Moonshot, setting the ambitious goal of reducing the cancer death rate by 50% over the next 25 years.Through genomic testing, precision oncology and immunotherapy, the goal is reachable, said Dr. Suresh Nair, Physician in Chief at Lehigh Valley Health Network’s Topper Cancer Institute, in an interview with Healthcare Finance News Executive Editor Susan Morse. Talking points:Innovations include strong robotic surgery programs for less invasive treatments and faster recoveryThe alliance reduces the delay between cancer research and care due to advancements in technologyThe Topper Cancer Institute, in the Lehigh Valley region of Pennsylvania, is participating in clinical trials on the molecular profiling of tumors. This is a real-time tumor tracking systemGenomic testing, precision medicine and immunotherapy will help reach the goal of the Cancer Moonshot to reduce the cancer death rate by 50% over the next 25 yearsThe combined expertise of multidisciplinary teams in cancer treatment can leverage new research and clinical trials, sometimes years ahead of other cancer research and treatmentThe alliance allows for the rapid deployment of increased standards of care – in real time – as new research becomes available.More about this episode:CMS expands coverage of lung cancer screening with low dose computed tomographyThe benefits of using genomic data for health systems and patientsCancer patients potentially overlooked in COVID-19 vaccine rolloutAetna launches gene therapy network as a standard medical benefitLack of diversity in clinical trials influences drug development

The rise in telehealth utilization, especially amidst the COVID-19 pandemic, has highlighted the potential of virtual care to expand access to services. These can be particularly important for those who may face hurdles to brick-and-mortar care. Dr. Jerrica Kirkley, co-founder and chief medical officer of Plume, joins Healthcare IT News Senior Editor Kat Jercich to discuss the potential of telemedicine for trans and gender-nonconforming people.Talking points:The need for data to support gender-affirming careThe dynamic, multifactorial process of providing services for LGBTQ peoplePatients are based across the country, including large metro areasYounger people are increasingly likely to identify as trans or gender-nonconformingInsurance coverage doesn't necessarily guarantee careWhat gender-affirming care entailsThe role of state licensing in telehealth expansionHow communities are being centered in careMore about this episode:More inclusive EHRs can help extend welcome, save transgender livesBeyond 'male, female, unknown' – informaticists propose gender-inclusive HL7 modelTelehealth has enabled wider access during COVID-19 – but not for everyoneStates can make a difference in long-term telehealth policiesDigital transgender health company Plume scores $14M in Series A funding

Given the strain on hospital resources caused by the pandemic, many informaticists have focused on the ability to try and predict patient populations. In January, researchers at the Regenstrief Institute and Indiana University found that machine learning models trained using statewide health information exchange data can actually predict a patient's likelihood of being hospitalized with COVID-19.Joining Healthcare IT News Senior Editor Kat Jericch to discuss the study's implications are two of its lead authors, Dr. Shaun Grannis and Suranga Kasturi.Talking points:How tools like this might be useful for health systems and hospitalsConnecting system-generated data with public healthHow COVID-19 has shined a light on cracks in different systemsThe Indiana Health Information Exchange as a data repository Seeing data-sharing blossom during the pandemicBiases in the model and how they can be addressedHow integrated data can be a powerful tool to shape policyMore about this episode:Regenstrief launches initiative to disseminate SDOH dataHIE-trained AI models can forecast individual COVID-19 hospitalizationData from 175K COVID-19 patients fuels predictive severity modelPredicting COVID-19 hotspots: Kaiser Permanente tool uses EHR data to forecast surgesEven innocuous-seeming data can reproduce bias in AI

In February, the federal government announced that the DOJ's Civil Division had recovered more than $5.6 billion in settlements and judgments under the False Claims Act, or FCA, for fiscal year 2021. This was a huge increase from the previous year – and almost 90% of that money was related to health industry claims. Joining Healthcare IT News Senior Editor Kat Jercich to discuss past and future enforcement initiatives is Ethan Davis, partner at King & Spalding.Talking points:A government wake-up on private equity enforcementDOJ's new cybersecurity initiativeHow COVID-19 shifted the federal approach to investigationsForthcoming focus on potential Provider Relief Fund fraud and clinical trial fraudThe Anti-Kickback Statute and how it affects providersEHRs as a stated area of focusWhat listeners should be aware of around telehealthHow stakeholders can protect themselvesPredictions for the rest of 2022More about this episode:OIG warns EHR vendors it will 'vigilantly' crack down on false claims tied to meaningful useDOJ slams Greenway with $57 million False Claims fineDOJ lawyer in Greenway case: EHR vendors are now on noticeCareCloud to pay $3.8M to settle kickback allegations with DoJAthenahealth to pay $18.25M for alleged False Claims Act violationsFlorida woman to pay $20.3M after using telemedicine to shield alleged fraudJudge awards whistleblower $390K in athenahealth kickback case

Fitbit Ionic smartwatches recalled due to burn risk; ONC analyzes information blocking claims. Plus: More than $1 billion in annual excess healthcare expenditure due to turnover of primary care physicians.Links to the stories:Fitbit recalls Ionic smartwatches due to burn hazardONC receives nearly 300 info blocking reportsPrimary care physician turnover leads to almost $980M in excess healthcare costs

Analysts and stakeholders have put a lot of energy toward trying to predict the future of telehealth: Are we at the peak of a bubble, or is it only up from here?A new report from Trilliant Health takes a measured view, arguing that telehealth use tapered in 2021 from its early-pandemic spike. Joining Healthcare IT News Senior Editor Kat Jercich to discuss the report is Sanjula Jain, Trilliant Health chief research officer and senior vice president of market strategy.Talking points:Contextualizing the data around telehealthTelehealth's market share as a parallel to luxury brandsWho's still using virtual care?Reasons for telehealth use ratesHow market segmentation can empower stakeholdersWhat this means for equityPsychographics versus demographicsPredictions for the futureTelehealth as a commodity good More about this episode:Study of 36.5M people reveals huge jump in pandemic telehealth useReport: Telehealth use beginning to taperLike it, love it, gotta have it? A health economist on attitudes toward telemedicineHealth systems see telehealth dip, but the tech is here to stayTelehealth revenue could hit $20B in five years, say analysts

This week: EHRs vulnerable to cyberattackers, agency claims; Senators urge CMS to keep Medicare Advantage rates stable. Plus: Mindler purchasing Medified Solutions Oy for an undisclosed sum.Links to the stories:HHS cyber arm warns of EHR vulnerabilitiesSenate calls on CMS to keep Medicare Advantage rates stableMindler scoops up Finnish mental health tracker Medified Solutions Oy

The HHS 405(d) Program was created as a provision of the Cybersecurity Act of 2015. It's designed to offer resources and best practices for healthcare organizations and public health agencies to help mitigate and respond to cybersecurity threats.Joining Healthcare IT News Executive Editor Mike Miliard to talk about 405(d), and the work that went into developing its cornerstone document, are Nick Rodriguez, program manager for 405(d) at the U.S. Department of Health and Human Services; Erik Decker, chief information security officer at Intermountain Healthcare and Eli Fleet, director of government relations at HIMSS.Talking points:A brief background on 405(d) and what it means for healthcare stakeholdersHow the HHS 405(d) Task Group was convened, with 150 individuals from government and the healthcare industryHealth Industry Cybersecurity Practices: Managing Threats and Protecting Patients, or HICP, a cyber preparedness 'cookbook' with recipes for readinessThe top 5 threats to cybersecurity, as described in that reportHow recent legislation is impacting 405(d) What healthcare organizations should be doing to avail themselves of these effortsWhere healthcare security leaders can find vetted cybersecurity practices and other resources for risk mitigationHow HICP will be evolving in the years aheadWhy "Cyber Safety is Patient Safety"What attendees can learn about cybersecurity at HIMSS22 in Orlando.More about this episode:5 key takeaways from Cybersecurity Act of 2015HHS releases voluntary cybersecurity guidanceSecurity chief touts the value of HICP, a cyber preparedness 'cookbook' with recipes for readinessHHS launches website for the 405(d) Aligning Health Care Industry Security Approaches ProgramThere's no 'magic bullet' to enhance cybersecurity, say expertsHIMSS Healthcare Cybersecurity Forum HIMSS22 Cybersecurity Command Center

A negative billing experience can cause patients to lose trust in a provider. Michael Axt, Chief Member Empowerment Officer for Zelis, talks about enabling the patient financial experience from initially shopping for services to post-service financial responsibility.