PBMs have been scrutinized for their role in rising drug costs. Executives say the model is on its way out. Gerenme via Getty Images LAS VEGAS — Executives from healthcare organizations as varied as Amazon’s online pharmacy, retailer Walgreens, insurer Blue Shield of California and drugmaker lobby PhRMA called for an end to the pharmacy benefit manager...
Category: <span>News</span>
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Amazon One Medical injected artificial intelligence tools into its clinics this week — aimed primarily at its doctors.
The tech aims to assist Amazon’s providers by writing notes from patient visits, summarizing medical histories, drafting messages to patients and helping coordinate care. That’s supposed to reduce administrative tasks by 40 percent, according to the rollout announcement.The company’s move suggests it believes the most immediate benefits of AI in health care will be for its...
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Early research on a new concussion sign to look out for
You probably know some of the classic concussion signs to watch for: Did the person lose consciousness? Appear dazed or confused? Have a change in mood? Research published this morning (like just now at 6 am ET) in Diagnostics has identified a new potential signal: “the spontaneous headshake after a kinematic event,” or SHAAKE. You’ve seen people...
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Humana sues HHS over calamitous Medicare Advantage star ratings decrease
It’s the latest in a string of lawsuits from health insurers scrambling to protect their prized quality scores and the money those ratings represent. Senate report slams Medicare Advantage insurers for using predictive technology to deny claims UnitedHealth, CVS and Humana used technology to increase MA prior authorization denials for post-acute services, boosting profits, according to a...
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Helene and CVS land double whammy for 25,000 patients who survive on IV nutrition
Credit: Unsplash/CC0 Public Domain The CVS representative popped into Lisa Trumble’s third-floor Berkshire Medical Center hospital room in Pittsfield, Massachusetts, to announce that everything was arranged for Trumble to return home, where she relies on IV nutrition because of severe intestinal problems that leave her unable to eat. That was on Tuesday, Oct. 8. The...
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Seniors are feeling the true cost of drug price “negotiations.”
Instead of saving money, some Medicare patients will pay more for medicines. Others may not be able to get their medicines – 89% of insurers and PBMs say they plan to reduce access to medicines in Medicare Part D because of the Inflation Reduction Act. Higher costs and less access. That’s not what seniors were...
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The bigger picture
Better diagnostics that make use of genomic profiling have wider applications than just precision medicine, the Broad Institute’s Adalsteinsson said. Blood tests can also help check the effectiveness of a treatment by essentially seeing how much residual cancer remains after a surgery, and whether further treatment is needed. Yes, but: Although the cost of genomic profiling has steadily...
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A select few doctor groups are behind telehealth’s GLP-1 boom
Over the last two years, dozens of telehealth companies have started to offer the wildly popular GLP-1 drugs. A new STAT examination has found that just a handful of networks of doctors, nurse practitioners, and physician assistants are writing prescriptions for the slew of websites offering the weight loss drugs, including the compounded versions that...
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Walgreens plans to close 1,200 pharmacies
Walgreens is closing 1,200 stores, or 14% of its locations, as it fights to turn around its business. UnitedHealth Group lowered its full-year earnings outlook, as it grapples with higher-than-expected medical costs and expenses related to the Change Healthcare cyberattack. The insurer said its medical loss ratio (the percentage of premiums spent on medical care) was about 85%...
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Money, peer pressure, and guilt: How UnitedHealth pushed doctors to diagnose more Medicare patients
In late 2020, an email from a UnitedHealth Group manager detailed the “#1 PRIORITY” for one practice. The goal was for doctors to document older patients’ chronic illnesses to generate more revenue from the federal government. As an incentive for seeing more patients, emails promised “ADDITIONAL BONUSES!!” Also, receiving a “SHOUT OUT!!” The latest investigation in...