Podnosis

Price transparency has been a regulatory priority over the past several years. While providers have had time to adapt and adjust, there remain common challenges that many run into as they look to comply with regulatory requirements.  Senior writer Paige Minemyer sat down with Turquoise Health’s AVP of Channel Sales Joe Wisniewski to outline these challenges, how hospitals can get ahead of the curve and lessons that payers can take away as regulations tighten for them, too.   To learn more about the topics in this episode:  Transparency has led to uniformity in healthcare costs—but not necessarily lower prices: white paper Price transparency startup Turquoise Health picks up $30M series B funding Hospital, payer price transparency compliance improves, but new requirements are kicking in this year GAO wants CMS to check whether hospitals' price transparency data are actually usable 'It isn't normal to operate the way they do': Senators condemn healthcare's resistance to price transparency See omnystudio.com/listener for privacy information.

Fierce Healthcare hosted the second annual Fierce Health Payer Summit in November. Top leaders and decision-makers in the healthcare and payer industry convened in Austin, Texas, for two days of discussions.   During the event, Fierce’s Emma Beavins interviewed several panelists on the show floor about what they think the ideal payer of the future looks like. In this episode, you’ll hear about improving the member experience, reforming prior authorization and leveraging AI.  The speakers featured in this episode are:   Alex Azar, former Health & Human Services secretary Tanvi Patel, general manager and director of Amazon Pharmacy Michael Anne Kyle, associate professor of health policy at the University of Pennsylvania Ed DeVaney, president of employer & health plans at CVS Caremark Brian Kim, CEO of HighRoads  See omnystudio.com/listener for privacy information.

Heather Cox, president of insights and empowerment at Zelis, discussed the challenges of achieving interoperability in healthcare during a recent podcast. She highlighted technical issues, diverse stakeholder needs and data silos as key obstacles. Cox emphasized the importance of real-time, secure data for payer-member engagement and suggested APIs as a promising solution. She also advised health plans on choosing technology partners and advocated for a data-centric approach to improve patient care. Listen to the podcast to learn more.See omnystudio.com/listener for privacy information.

Our early experiences as kids have a lasting impact on our health and wellbeing. From facing adverse childhood experiences to various social needs, kids are especially vulnerable to their environment, as their brains are still developing. Schools play a crucial role in helping to support kids. However, our education system today does not do enough to equip children to understand their mental wellbeing and emotions. So argues Jessica Gomez, Psy.D., a bilingual psychologist in Texas. Gomez is executive director of Momentous Institute, a nonprofit offering mental health services and operating an elementary school in Dallas.  In this week's episode of "Podnosis," Gomez walks Fierce Healthcare's Anastassia Gliadkovskaya through the importance of integrating social-emotional learning into education and how doing so early on can have lifelong benefits.   To learn more about the topics in this episode:  California is funding managed care plans to bring mental healthcare to schools. Here's how it's going Experts weigh in on how to tackle growing teen mental health crisis Evernorth: How employers can take the lead on addressing youth mental health Cigna taps first 22 awardees in grant program targeted for youth mental health See omnystudio.com/listener for privacy information.

Join Dr. Heather Bassett, Chief Medical Officer at Xsolis and seasoned healthcare innovator with over 20 years of experience, as she dives into the transformative power of AI in healthcare. She shares her vision for a patient-centric system enhanced by technology. Dr. Bassett discusses the shift from traditional machine learning to generative AI, emphasizing responsible implementation and the importance of leadership. She also addresses healthcare's pressing challenges, like clinician burnout and regulatory hurdles, while providing insights on optimizing AI investments.

Nichole Sweeney, General Counsel and Chief Privacy Officer of CRISP Shared Services, is a leading expert in health data privacy. In this discussion, she highlights the critical need for interoperability among healthcare systems while addressing concerns over sensitive patient data, especially in light of the Roe v. Wade overturning. The conversation delves into Maryland's proactive legislation on reproductive health data, the complexities of patient opt-out processes, and the importance of informed consent amid varying state laws.

American Specialty Health Incorporated's ASH Care fall prevention program offers virtual assessments and exercise regimens to address falls among older adults. The program combines remote physical therapist evaluations, personalized exercise plans and coaching to improve balance and strength while reducing fall risks. Initial results show 60% to 75% of participants experienced improvements in outcome measures, with statistically significant gains in balance, strength and reduced fear of falling. ASH Care aims to enhance older adults' health and independence while potentially lowering healthcare costs associated with fall-related injuries.See omnystudio.com/listener for privacy information.

The National Committee for Quality Assurance (NCQA) has long prioritized quality in healthcare, but the COVID-19 pandemic underscored the critical role of equity as a cornerstone of quality. In recent years, NCQA has refined its HEDIS measures to be more inclusive and to better address sociodemographic factors that influence health outcomes. In this week's episode of "Podnosis," Rachel Harrington, Ph.D., assistant vice president of health equity sciences at NCQA, shares insights into the organization’s efforts to measure and improve health equity. She discusses the importance of collecting race and ethnicity data to identify and address disparities, the challenges and progress in data collection and upcoming changes to HEDIS measures in 2025. To learn more about the topics in this episode:  NCQA released its annual health plan ratings. Here's how payers fared How incentives engage and keep patients healthy  How providers are leveraging patient engagement tools to close gaps in cancer screenings See omnystudio.com/listener for privacy information.

Cyberattacks against healthcare organizations are becoming increasingly sophisticated, with new threats constantly emerging.  In this week's episode of "Podnosis," we dive into one of the latest tactics: voice phishing, or vishing. This form of cyberattack uses AI to impersonate voices over the phone to gain unauthorized access to sensitive information. Fierce Healthcare's Anastassia Gliadkovskaya interviews Nametag CEO Aaron Painter, who explains what vishing is, why it's a growing concern, and how organizations—especially in healthcare—can protect themselves.  To learn more about the topics in this episode:  Disruptive cyberattacks against healthcare on the rise, with increasing impacts to patient care, survey finds 100M people impacted by massive Change Healthcare cyberattack: OCR Providers and payers ramp up investments in cybersecurity, AI in 2024 Change Healthcare begins breach notifications to firms with impacted members, patients Cybersecurity lessons from the Change Healthcare hack See omnystudio.com/listener for privacy information.

In this insightful discussion, Alexander Saint-Amand, Co-founder and CEO of Topography Health, tackles the complex issues surrounding U.S. clinical trials, particularly for marginalized groups. He highlights the logistical and financial barriers limiting access and the decline in physician participation. Saint-Amand passionately advocates for enhancing trust and infrastructure within the sector, emphasizing the potential of AI to streamline patient recruitment. Additionally, he discusses strategies for engaging underserved communities in meaningful clinical research.