US hospital systems validate the safety, clinical utility, and robustness of newly FDA-approved devices, 510(k) cleared, before adopting them into clinical practice. This work occurs alongside evaluating how to integrate the medical device into the hospital system’s diagnostic paradigms, including in relation to quality improvement programs. Companies can have a role but there are 415 US hospital systems (comprising ~5,000 hospitals), and each has a bespoke process and ever-changing set of
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Medicaid | Medicaid Patients | Medicaid Reform | Regulation, Policy, Analysis, Insights - HIT Consultant
Healthfirst and MediSys Launch FHIR Platform, Hyphen
What You Should Know:
- Healthfirst and The MediSys Health Network announced today they are using Hyphen to connect longitudinal data from claims, quality measures and electronic health records (EHRs) to identify gaps in care, making it easier for clinicians to address patient needs in real-time.
- Hyphen is a cloud-based platform that uses Fast Healthcare Interoperability Resource (FHIR) standards to share member data directly into provider or hospital EHR systems, along with patient- and
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Brave Health Raises $40M for Medicaid Virtual Health Platform
What You Should Know:
- Brave Health, a virtual mental health provider and engagement platform focused on serving Medicaid populations raises $40M in Series C funding round led by Town Hall Ventures, with existing investors Union Square Ventures, City Light Capital and others joining as well. The company has raised a total of $60M to date, and this most recent funding will support their continued expansion into value-based care arrangements and into new and existing markets.
- Brave
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The Botched COVID-19 Response and What We Can Learn from It
The COVID-19 pandemic has completely transformed the World Order and exposed striking realities of the global healthcare infrastructure by revealing the tendencies of various countries to deal with public healthcare emergencies. It has further raised the curtain on global hegemons like the U.S.A., which lacked the capacity and finances to counter this disaster. This has intensified the need for reforms and strong legislation to mitigate the pandemic’s devastation on healthcare facilities.
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Aetna Taps Emcara Health to Deliver Home-Based Primary Care to 240k Medicaid Patients
What You Should Know:
- Emcara Health and Aetna Better Health, which announced that the two companies will be partnering to deliver primary care in the home to more than 240,000 Medicaid patients in the Miami/Dade and Tampa, Florida regions.
- The relationship extends Emcara Heath’s comprehensive primary care model – which includes behavioral health and social determinants of health assessments – to adult Aetna Medicaid members.
Partnership
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State Price Transparency Requirements Are No Longer Cut and Paste
For pharmaceutical manufacturing firms, the amount of documentation required around state price transparency regulations continues to expand. As it now stands, more than 22 states have transparency laws on the books, and each of these states requires a complicated and diverse set of reporting information, which was not the case five years ago.
These transparency requirements – including the need to provide data in different formats and on different dates due to “triggering events” – mean that
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Grow Therapy Raises $75M to Expand Insurance Coverage for Mental Healthcare Nationwide
What You Should Know:
- Behavioral health company, Grow Therapy secures $75 million in series B funding to expand insurance coverage including Medicare and Medicaid in all 50 states.
- This round of funding was led by TCV, co-led by Transformation Capital, with support from existing backers SignalFire and SVB.
Medicare/Medicaid Coverage Expansion
Specifically, the areas that the company will focus on are: expanding commercial insurance and Medicare and Medicaid coverage (which are
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Cityblock Health & MDwise Brings VBC to 10K Medicaid Members in IN
What You Should Know:
- MDwise and Cityblock Health, the first tech-driven healthcare provider for communities with complex health and social needs announced that they will be collaborating to provide high-quality, comprehensive care to 10,000 Medicaid members at launch in select Indiana communities, including Indianapolis.
- As part of this strategic collaboration, Cityblock will open comprehensive care clinics to provide care services for these individuals, addressing physical
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Edifecs Launches Solution to Automate Prior Authorization at the Point of Care
What You Should Know:
- The full automation of prior authorization at the point of care leads to improved member experiences, enhanced outcomes, ongoing compliance, and reduced administrative burden. Edifecs’ automated prior authorization solution integrates with electronic health records (EHR) and leverages artificial intelligence (AI), natural language processing (NLP), and industry standards such as FHIR to instantly deliver authorization.
- This innovation comes on the heels of
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30% of First-Time Opioid Prescribed Patients Developed Dependency
What You Should Know:
- Gainwell Technologies, a leading innovator in healthcare technology solutions, has partnered with top academic institutions to drive research addressing some of the nation’s biggest healthcare challenges.
- Using Gainwell’s advanced research platform and de-identified Medicaid claims data from select clients, Stanford concluded that 30 percent of patients prescribed opioids for the first time developed a dependency. This is a critical finding in the search for
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