Literature Review

Senate ramps up push to reform doctors' Medicare pay Modern Healthcare; by Michael Mcauliff; 5/20/24Declining doctors' pay in Medicare is getting its most serious look in nearly a decade in the Senate, with a bipartisan push launched Friday by the Senate Finance Committee. Doctors have grown especially vocal in recent years about falling Medicare reimbursement. Groups including the American Medical Association have estimated doctors were effectively getting paid 26% less in 2023 than in 2001 because the physician fee schedule set by the Centers for Medicare and Medicaid Services is not adjusted for inflation. Physicians have also called for more flexibility within the pay system.

CVS could lose 10% of its Medicare Advantage members in 2025Becker's Payer Issues; by Rylee Wilson; 5/14/24CVS Health executives are bracing to lose up to 10% of Aetna's Medicare Advantage members next year, Bloomberg reported May 14. At an investor conference on May 14, CVS CFO Tom Cowhey said it's "entirely possible" the company loses a portion of its members in the coming year as it prioritizes profitability, according to Bloomberg. "That's OK because we need to get this business back on track," Mr. Cowhey said. Executives at CVS Health have said they will prioritize "margins over membership" in Medicare Advantage in the coming year.

Telehealth is far from dead, says Providence’s Virtual Care ChiefMedCity News; by Katie Adams; 5/15/24This year has been a messy one for virtual care companies, but that doesn’t mean that telehealth is dead, according to Eve Cunningham, Providence’s chief of virtual care and digital health. In her view, virtual care can definitely still be an important part of the care delivery model — but only if it is embedded into the greater healthcare delivery ecosystem. This year hasn’t been a great one for virtual care companies. Optum shuttered its virtual care unit in April, Walmart closed its virtual care offering (as well as its entire healthcare unit) in May, and two of the country’s largest telehealth providers - Teladoc Health and Amwell - have both enacted major rounds of layoffs this year. But this doesn’t mean telehealth is dead, said Eve Cunningham, chief of virtual care and digital health at Providence, during a Tuesday interview at the Reuters Digital Health conference in San Diego.

The human side of AI: Insights on balancing automation and empathy Innovation & Tech Today; by Enrico Palmerino; 5/20/24 ... As AI automates more tasks with clinical precision, empathy is a critical human element we cannot overlook. That intangible ability to understand and share the feelings of another isn’t just a soft skill — it’s an essential catalyst for trust, loyalty, and genuine connection. Consider the healthcare industry, where empathy is (quite literally) often a matter of life and death. Can an AI-powered diagnostic system truly grasp a patient’s fear and vulnerability when facing a serious illness? ... Finding the delicate balance between leveraging AI automation and preserving human empathy is the new challenge before us. It’s a duality that will shape how businesses operate and how we interact with technology. ... Let the machines optimize processes while we optimize the ability to connect and inspire. In this harmonious future, AI is a tool that elevates us — not replaces us.Editor's Note: Is AI a hot topic among your leaders and interdisciplinary clinicians? Often, "empathy" and "communication" are cited as key cautions and conflicts. 

Breaking down walls: The other care models marking their territory in home-based careHome Health News; by Joyce Famakinwa; 5/17/24Traditional home-based care companies aren’t the only ones serving seniors, while helping shift care away from brick-and-mortar settings. Adult day, PACE and continuing care retirement communities (CCRCs) without walls are a few of the care models working to meet the needs of seniors that want to age in place. In many ways, these care models are natural allies to home-based care providers.

PE Sponsors Of Comfort Keepers, New Day Healthcare Are In Home-Based Care For The Long HaulHome Health Care News; by Joyce Famakinwa; 5/13/24While some private equity investors have been sidelined by macro and micro headwinds, there are still plenty of PE firms invested in home-based care that like where they are.

Sanction-free InnovAge faces new challenges in Colorado, California during fiscal Q3McKnight's Home Care; by Adam Healy; 5/14/24InnovAge posted a loss in its third fiscal quarter, but executives of the for-profit Program of All-inclusive Care for the Elderly provider said business will only continue to improve as temporary headwinds fall by the wayside. “The company’s third quarter results were largely consistent with our expectations,” Patrick Blair, president and chief executive officer, said during a third quarter earnings call last week, according to a transcript. “We continue to see ongoing performance improvement in every facet of our operations which is driving greater stability in our financial results and increased confidence in our ability to deliver high-quality care and a great participant experience while also growing our top and bottom lines.” During the quarter ended March 31, InnovAge lost $6.1 million. That compares to a $7.3 million loss during the third fiscal quarter of 2023. Revenues grew by nearly 12% year-over-year to $193 million.

UnitedHealth Group's Optum to close Ohio location, lay off 129Modern Healthcare; by Lauren Berryman; 5/17/24UnitedHealth Group’s Optum will lay off 129 employees and close a Toledo, Ohio, facility, according to a notice filed with the state's job and family services department. The separations are expected to take place in three waves, from July 15 to September 6, and will affect employees in Ohio and remote locations, Optum said in the Worker Adjustment and Retraining Notification Act notice filed Thursday. The affected employees include senior software engineers, senior technology product managers, associate business systems analysts and associate business operations coordinators, the notice said.

Have a heart – caregivers need care, tooAmerican Heart Association; 5/14/24Living with a chronic medical condition after surviving a heart attack or stroke may come with additional health and personal care needs. Often survivors must rely on a family member or close friend to help. However, there’s a growing body of scientific research that shows people who serve as unpaid caregivers may not be getting the care they need to live longer, healthier lives, according to the American Heart Association.

Cybersecurity execs share healthcare's biggest vulnerabilitiesModern Healthcare; by Brock E.W. Turner; 5/20/24A recent string of massive healthcare cybersecurity breaches has put data security leaders on edge. Recent incidents have shined a light on some of the most significant vulnerabilities at health systems. Here are four of the biggest, according to experts.

Kaiser to sell $3.5B in PE funds: WSJBecker's Hospital CFO Report; by Alan Condon; 5/13/24Oakland, Calif.-based Kaiser Permanente plans to sell up to $3.5 billion of holdings in private-equity funds due to cash constraints, The Wall Street Journal said in a May 12 report citing unnamed sources "familiar with the matter." Kaiser is working with investment bank Jefferies Financial Group to offload up to $3.5 billion of stakes to secondary buyers, but a spokesperson for the system told Becker's that the recent shift in investment out of private equity is not driven by liquidity concerns.

The Pennant Group acquires hospice provider Nurses on WheelsHospice News; by Jim Parker; 5/16/24The Pennant Group, Inc. (NASDAQ: PNTG) has acquired the Corpus Christi, Texas-based hospice provider Nurses on Wheels Inc. for an undisclosed amount. This is the latest in a string of acquisitions for Pennant. Earlier this month Pennant acquired Utah-based South Davis Home Health and South Davis Hospice. The company in December 2023 picked up Arizona-based Southwestern Palliative Care & Hospice after acquiring five Medicare hospice providers in multiple states the prior month. Financial terms were not disclosed in these deals.

Modern Healthcare's Best Places to WorkPublisher's Note: On 5/20/24 we ran Modern Healthcare story recognizing Teleios as one of the best places to work in healthcare in 2024. We would like to recognize all hospice and palliative care providers on this list, including: