Hospitals prosper on commercial payers as Medicare margins sink to -9%

Margins on hospital Medicare business are expected to deteriorate this year, bottoming out at a negative 9% on average, according to a report by the commission that advises Congress on Medicare payments. But the good news is that hospitals are making healthy profits and surpluses overall on the strength of productivity gains, cost-cutting and their commercial business, the Medicare Payment Advisory Commission said in a little-reported study in March.

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Abena

Abena is a Danish, family-owned company manufacturing incontinence products, health care products, and baby diapers. Besides our own production in Denmark, Sweden, and France we also supply a wide range of sourced products such as; gloves, body wash, skin care, wound care, food service and paper.

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Health Technology, Digital Healthcare

What are the Key Types of Healthcare Supply Chain Management Solutions?

Article | September 7, 2023

Introduction Within the last two years, the healthcare industry saw an influx in patient care as COVID-19 swept through communities across the globe. The widespread shortage of patient care tools, personal protective equipment (PPE), and medical technology amid the pandemic led to an exponential rise in health expenditures and demand for essential supplies. In response to the medical demand-supply imbalance, the governments of numerous countries increased their medical care expenditures to counter the challenges of patient care equipment shortages. For instance, according to the National Healthcare Expenditure Data, federal government spending on healthcare and medical care grew by 36% in 2020 and is estimated to reach US$ 6.2 trillion by 2028 in the U.S. Despite the rise in medical budget allocations, medical facilities are still facing difficulties obtaining enough supplies with the growing prevalence of numerous chronic, infectious, and hereditary diseases. As a result, organizations are focusing on deploying innovative solutions, such as healthcare supply chain management software, to keep track of inventory, procurement, logistics, and others and strengthen their supply chain. Healthcare Supply Chain Management Solutions: Key Types Healthcare systems, hospitals, and other patient care sites require a broad array of supplies to perform diagnosis and treatment, from masks and gloves to catheters and implants. Inadequate supplies coupled with inflation is making supply chain management a crucial but complex component in providing optimal patient care across the healthcare industry. This has shed more light on the role of supply chain management in saving lives. Effective supply chains help various regulatory agencies, including medical goods manufacturers and insurance companies, deliver essential supplies, resources, technologies, and other patient care goods to healthcare establishments. Supply chain management solutions are thus garnering massive traction among healthcare organizations for simplifying and automating manual supply chain and logistics operations. Let’s have a look at the types of supply chain management software that assist healthcare organizations to optimize their supply chain processes Inventory Management Software Efficient medical inventory management is critical for the running of healthcare organizations. The software provides real-time inventory tracking, assisting organizations in closely monitoring inventory changes, avoiding shortages of both low-value and high-use patient care items, decreasing the wait time for access to medical supplies, and reducing the chances of late delivery. Order Management Software It is crucial for healthcare establishments to have an estimate of the demand and supply of goods to prevent shortages. Order management software enables these organizations to coordinate supply chain demand planning and forecasting. It also assists in streamlining warehouse operations, resulting in faster and more accurate order placement. Sourcing and Procurement Software By tapping into the power of sourcing and procurement solutions, healthcare organizations can develop robust sourcing processes and automate, streamline, and optimize their entire procurement processes. The software also assists establishments in improving their supply inventory levels, identifying the best supplier, and reducing their overall purchasing cost. Shipping and Tracking Software Shipping and tracking software assist in the planning and execution of the physical movement of goods. These solutions are primarily used by medical equipment manufacturers and suppliers during the delivery or relocation of patient care goods. The integration of these solutions enables organizations to track and manage numerous batches of goods in transit. The Bottom Line Growing competition, healthcare regulations, shipping costs, and increased logistics requirements from medical institutions have complicated the supply chain management processes. As a result, life-science companies are investing in cutting-edge supply chain management solutions to reduce numerous errors, improve logistics, and eliminate unnecessary costs spent to fix them. Thus, several companies are now emphasizing the incorporation of cutting-edge technologies, including artificial intelligence and data analytics, into healthcare supply chain management software to reap benefits such as process automation, streamlined inventory, reduced waste, improved decision-making, and lower labor, supply, and operational costs.

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Healthtech Security

AI Trends: AI and Medicine

Article | November 29, 2023

Artificial Intelligence is here to improve our lives, by not just making things more efficient, but also increasing our lifespan. Companies across industries are experiencing the advantages that come with AI innovation, especially the healthcare space. Throughout human history, we’ve been able to understand the parameters that determine health better, and we’ve developed accompanying technology. With vaccines in the late 1700s, anesthesia and medical imaging in the 1800s, to organ transplant and immunology in the 1900s, healthcare innovation has been on an upward slope.

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Health Technology, Digital Healthcare

Choosing your health plan: HMO? PPO? Why not DPO?

Article | August 21, 2023

The fall is a time of renewals and choices. It is also a time of so called “open enrolment” for health plans. It is the one time of year we can study and learn about the options offered through employers or government sponsored plans. Individuals and small business owners alike are also are faced with a myriad of choices with confusing and often contradictory language promising lower premiums with higher out of pocket costs for covered services subject to deductibles. What does it even mean anymore when your monthly premiums exceed your pay check and you still have to pay for your colonoscopy or your insulin? Where is it all going? Let’s imagine you twist your ankle playing basketball. You might go to an urgent care, receive an X-ray, probably be examined by a non-physician, and then referred to your primary care, who can’t see you for a few weeks but eventually sends you to an orthopaedic who takes another X-ray and treats your injury. Weeks have passed, multiple visits, time out of work, and co-pays, not to mention the out-of-pocket fees associated with imaging and perhaps a $100 ace bandage. What stops you from going straight to the ankle specialist in the first place? First, we have become conditioned to follow the directions dictated by the insurance companies, even when restrictions are not in place, patients have been convinced that stepping out of line will make all insurance promises null and void resulting in catastrophic bills and financial ruin. Second, the doctors and their office staffs have been conditioned to deny entry to any patient who does not have the proper referral, authorization, or identification. There are dire consequences for both if the insurance rules are not followed and fear keeps both sides aligned. The past two decades have seen an explosion of healthcare costs. Health insurance has become the single biggest line item second only to payroll for most businesses. It is no coincidence that as the government increased its role as payor with state subsidies, the prices have gone up. Much like college tuitions, when loans are easy to obtain and guaranteed by federal support, there is little to deter those in charge from increasing the price. After all, everyone is doing it, it must be OK, and even if students end up in debt, it will be repaid because they have received the value of a great education. Right? But unlike higher education, healthcare is a necessity. We cannot avoid it, and there needs to be a reliable mechanism in place to guarantee access. Ironically, as charges and prices have continued to escalate, payments to doctors have diminished. Why medicine is the only service industry where there is no transparency is truly astounding, especially since the there has been no increase in so called “reimbursements” for decades. As physicians, we have been complicit, being fully aware of the discrepancies between what is charged and what a patient’s insurance will pay. Even as patients began to have higher deductibles, and therefore higher out of pocket expenses, we continued to follow the rules, asking insurance permission to collect payment from the patient. It is not surprising that bad debt accounts for over 50% of most account receivables and why over 70% of doctors are now employed by hospital networks or private equity, who not only go after patients, but benefit from the repricing that occurs when insurers pay a negotiated amount as opposed to the charge. In other words, we pay more not just for less, but for nothing. But what if we twisted our ankle and went directly to that specialist and paid out of pocket a transparent price? What would it take for that to happen? Not much, the cost of care is predictable, and because payments have always been decreasing, most physicians have learned to be economical. Plus, out of pocket costs are capped by federal law, so no patient is really responsible for catastrophic bills. Charges inflate to cover overhead, but if payments were guaranteed and immediate, then the cost of doing business goes down. Add technologies like telemedicine to a practice and you have increased patient access to a doctor without adding more personnel. Direct pay doctors are emerging all over the country and have consistently offered better access and more affordable care. The bar is also being set by independent surgery centers and imaging centers who offer better outcomes at lower costs. Perhaps motivated by prohibitive pricing, better options have emerged that have moved patients away from expensive operating rooms to safe, office-based procedures. Even cutting-edge cancer therapies can be delivered at home, preserving more of the healthcare dollar for medical care rather than the complex system built to manage it. Competition and choice inevitably drive prices, but in a monolithic system the price is not negotiated, but instead it is set by only a few, in this case the big insurers. Small businesses cannot compete when bigger companies come to town. Eventually, the local hardware store gives way to a national brand, and the consumer is left with fewer choices and eventually higher prices. Amazon disrupted this equation by creating a marketplace for individual buyers and sellers. The convenience of finding a trusted brand, no longer available locally, is irresistible and the reason why we became loyal consumers. Healthcare is no different. Trust exists implicitly between a physician and patient, because it is an authentic, empathetic, and logical relationship. Trust does not exist between a patient and their insurer, on the contrary it is an unsympathetic business relationship without transparency or consistency. Few doubt the insurance company’s top priority is the premium, not the patient. Creating a direct relationship between the doctor and patient is a common-sense approach that serves both stakeholders well, and requires merely a fair and affordable price. But do doctors have the capability or the will to do it and if so, can the rest of the system follow? Never in the history of modern medicine have physicians been more dissatisfied. US healthcare used to lead the world in innovation and outcomes, now we struggle to break the top thirty. We may have the most brilliant doctors and scientists with access to the best resources, but the need to maximize profits while catering to special interests, be they commercial or political, has led us to favour certain therapies over others despite marginal proven benefits. Doctors have little autonomy and less authority; prescribed treatments are routinely denied by insurance companies without a second thought or appropriate peer review. In fact, insurers even renamed us “providers”, a term used to by Nazis when referring to Jewish doctors to devalue them professionally. Over 56% of physicians are burned out, nearly all report moral injury and as hospitals have systematically replaced doctors with non-physicians with limited training, we have watched the standard of care deteriorate. It is no wonder we have witnessed the single biggest loss in life expectancy since WWII. The prognosis is grim, but there are solutions. We need to reinvent healthcare by removing the middleman. We don’t have to set the price, but we can make it transparent so patients can decide for themselves if it is worth the inconvenience, the delay, and the co-pay to use insurance or just pay directly. Health savings accounts are tax deferred and can cover an out-of-pocket maximum in just a couple of years. Paying for care means there are no surprise bills or out of network costs, because there are essentially no networks and therefore no need to follow restrictions. You’d be hard pressed to find a doctor or hospital unwilling to accept an immediate cash payment, especially when it costs nothing more than the service provided. There are no billing cycles, or claims to prepare, no up coding, or authorizations. Doctors free to care for patients, patients treated individually and not subject to protocols designed to maximize charges. There are literally thousands of direct pay primary care and specialists now available all over the country and they are building alliances with likeminded people providing imaging, ancillary services, surgery centers, and prescriptions all at fair market prices. More and more employers are moving toward medical cost sharing plans that not only lower the cost of care but the cost of administration. Even the biggest payor, namely the government, sees the benefit of price transparency and is piloting models of direct contracting. We will always need coverage for those unexpected events, emergencies, or hospital-based services, but all the rest - doctor visits, screening tests, and outpatient procedures - are easily affordable. After all, do we use our car insurance to pay for an oil change? If we did, the cost would be prohibitive and few of us would drive. But health insurers have lost our trust, they no longer cover necessary services and no longer honour contracts with physicians or patients. It is time to offer another option and let the patients and doctors get back to the real business of medicine.

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Health Technology, Digital Healthcare

Top 10 Best Practices for EHR Ethical Issues

Article | August 21, 2023

Discover the potential of EHR implementation in revolutionizing clinical processes. Uncover strategies for addressing EHR ethical issues, ensuring integration that prioritizes patient-centered care. Amidst the fusion of healthcare and technology, integrating electronic health records (EHRs) has emerged as a transformative element in modern medical practice. As a digital repository for a patient's medical journey, EHRs present unprecedented prospects for elevated care quality, improved data accessibility, and cost-effectiveness. Nevertheless, these advancements bring forth an array of EHR ethical issues that demand meticulous attention. In this context, establishing and adhering to the best practices for the ethical training of EHRs assumes paramount importance and a moral obligation. By skillfully navigating the intricate convergence of technology, patient confidentiality, and conscientious healthcare, these ethical EHR best practices illuminate the path toward a future where innovation and ethical principles harmoniously coexist. 1. Upholding Privacy and Confidentiality Revealing a patient's information to external parties should strictly happen with the patient's explicit consent or within the parameters defined by legal regulations. Data stemming from clinical interactions is confidential and requires rigorous protection. The effective operation of EHRs requires authorized access by healthcare institutions, insurers, and related entities. Access by users is contingent upon predefined role-based privileges. The administrator identifies users, specifies the extent of information accessibility, and allocates exclusive usernames and passwords. Users must be conscientious about responsibly utilizing the information they access within their designated roles. Therefore, assigning user privileges plays a pivotal role in securing medical records. However, while regulating data access remains crucial, it doesn’t completely ensure confidentiality. Strengthening security through comprehensive privacy and security protocols remains essential for reinforcing patient data's inviolabilit. 2. Safeguarding Against Data Breaches Ensuring patient privacy and safeguarding sensitive medical data is paramount in EHR ethical training. The imperatives of inadequate data security, encompassing compromised medical information, unauthorized access due to weak password safeguards, and the lack of encryption, accentuate the immediate need for a holistic approach. Employing strategies such as secure cloud storage, robust password protocols, two-factor authentication, and encryption is pivotal in enhancing data security, preventing the mishandling of patient records, and abiding by ethical standards. The potential legal and financial consequences of breaches underscore the criticality of these practices in maintaining patient trust and confidentiality within the digital healthcare domain. 3. EHR System Implementation The integration of EHRs within healthcare organizations poses significant challenges, including resource waste, provider dissatisfaction, diminished patient trust, and potential safety risks. Successful EHR development, implementation, and upkeep demand substantial investment and collaboration among stakeholders, including clinicians, IT experts, educators, and consultants. Clinicians' active engagement is often underestimated, leading to the failure of EHR projects; therefore, clinician-led guidance is crucial in tasks such as EHR selection, workflow design, and quality improvement. Thoroughly mapping workflows before selecting an EHR is crucial, while maintaining user-friendly interfaces remains essential for success. Neglecting these aspects can reduce efficiency, compromise care, and increase safety threats. By prioritizing comprehensive planning, engaging clinicians, and optimizing user interfaces, healthcare institutions can ensure ethical and efficient EHR integration, ultimately enhancing patient care and safety. 4. Maintaining Data Accuracy Upholding data accuracy stands as a fundamental principle in the ethical EHR domain. The integrity of information guarantees its unaltered and precise nature, contributing significantly to the enhancement of patient safety, reduction of healthcare errors, mitigation of health disparities, and betterment of public health. Nevertheless, concerns have been voiced regarding the reliability of data input into electronic records. The improper utilization of functionalities such as 'cut and paste' can lead to misleading portrayals of a patient's condition and treatment, breaching ethical standards. This practice poses elevated risks to patients and increases the liability of clinicians and institutions. Challenges also arise from drop-down menus that limit a clinician's choices, potentially giving rise to substantial errors, especially under time constraints. The collaborative efforts of clinicians and vendors can address software concerns, promoting user-friendly, reliable EHRs while tackling EHR ethical issues. Furthermore, data loss during transfers raises pertinent concerns about the accuracy of the database, a critical aspect as patient care decisions hinge on this data. 5. Guaranteeing Data Authenticity The assurance of documentation integrity pertains to the accurate and precise nature of the comprehensive health record. This includes principles of information governance, identifying patients, validating authorship, handling amendments and corrections in records, and auditing documentation validity while submitting reimbursement claims. EHR tools offer flexible documentation options through the utilization of templates and smart phrases, assisting in precise record-keeping. However, if these tools are misused, doubts about data integrity can arise, making information unreliable and possibly raising concerns about fraudulent activity. Established policies and procedures, including audit functions, must be in place to ensure proper billing. With adequate safeguards, records may accurately represent the patient's condition at admission and over time. Providers must understand the importance of reviewing and refining default data to ensure that only patient-specific information for that visit is recorded. In contrast, irrelevant data from default templates is removed. 6. Validating Dictation to Prevent Errors Voice recognition systems lacking a validation step pose considerable challenges in maintaining data accuracy and preventing documentation errors within organizations, particularly when it comes to ethical issues with electronic health records. EHR companies need to implement a protocol requiring providers to promptly assess, modify, and validate dictated information. Given these documents' frequent use and sharing, precise and high-quality documentation in EHR systems is of utmost significance. The adoption of EHRs has led to substantial shifts in provider workflows and documentation processes. However, providers still need to clearly outline or fully understand comprehensive best practices for maintaining high-quality documentation in EHRs. Advancements are necessary to enhance documentation tools and methods, with a renewed emphasis on the essential aspects of data accuracy and quality. This should precede the widespread implementation of interoperable health information exchange initiatives. 7. Ensuring Accurate Documentation Maintaining the integrity of documentation is compromised when incorrect information finds its way onto the wrong patient's health record. Patient identification errors can influence clinical decisions, endanger patient safety, violate privacy and security, and lead to redundant testing and escalated expenses for patients as well as providers. The propagation of patient identification mistakes can rapidly expand within EHR, personal health records, and Health Information Exchange (HIE) networks as information disseminates. Failing to implement advanced front-end solutions that incorporate robust matching algorithms or innovative techniques like biometrics or fingerprinting can expose organizations to risk. EHRs can incorporate targeted alerts to anticipate safety problems, like blood type inconsistencies or allergies, during treatment, addressing EHR issues. Organizations must institute a patient identity integrity program, integrating performance improvement metrics to monitor error rates and duplicate records in their electronic master patient index. Policies and procedures must ensure the accuracy of critical demographic data, facilitating the linkage of records within and across systems. Addressing the initial point of data capture as a primary front-end verification is also vital within policies. 8. Preserving the Authenticity of Audit Trails Effective audits are crucial to ensuring that the health record documentation aligns with the reported level of service, fulfills reimbursement requirements set by payers, and guarantees that only authorized personnel access patient medical records and make entries. The audit trail must encompass the user's name, the triggering application, workstation details, the specific document, a description of the audited event (such as amendments, corrections, or deletions), and the timestamp. This audit trail outlines modifications (including deletions) within the health record and provides auditors with a foundation for compliance audits. Inadequate audit trail functionality within EHRs raises concerns about the integrity of health record documentation, potentially exposing organizations to legal liabilities and inadvertently fostering or shielding criminal activities. It may become challenging to ascertain if corrections or amendments were executed, who authorized the changes, or the nature of the modifications. In addition to the inherent unintentional errors that documentation might encounter, audit trail functionality can aid in detecting instances where records are altered to obstruct the disclosure of detrimental information. Organizations can utilize EHR trends to leverage audit trail features for identifying and analyzing patterns in health record usage. Typically, users can generate reports over specific time frames categorized by provider or provider type, with results directed to a compliance committee or the organization's governing body. 9. Fostering Compliance Awareness Enhancing ethical EHR training involves a strategic focus on ensuring providers are well-versed in compliance and legal risks, starting from the EHR training phase. To address EHR problems, organizations should implement educational initiatives aimed at mitigating compliance issues. Staff education must emphasize the integrity of health record documentation, with a continuous program monitored and provided quarterly or annually. Addressing the 'who, what, why, and how' ensures a solid grasp of organizational practices that uphold individual best practices, encompassing identifying potential fraud, universal and administrative security measures, data validity, authorship, continual education's significance, and strategies for daily fraud prevention. 10. Conducting Feedback Sessions Contrary to common assumptions, ongoing training is essential post-EHR implementation. After installing the EHR and initiating patient interactions, challenges inevitably emerge—be it staff unfamiliarity with functions or the need to revamp workflow processes. Promptly identifying these concerns to prevent errors and swiftly resolving them involves collecting feedback from EHR users among the staff, particularly in relation to EHR ethical issues. During the weeks after the system's launch, contemplate arranging routine meetings to gather insights. Ensuring diverse representation, including clinical staff, physicians, administrators, billing, and front desk personnel, is crucial. Seek input on their adaptation to changes and areas requiring improvement. Determine if specific training concepts need reinforcement. Surveys can be used in place of frequent meetings. Subsequently, prioritizing problem areas aids focused resolution by promptly addressing critical matters. The introduction of incremental changes helps staff adapt to the EHR seamlessly, safeguarding patient care continuity during the transition. The Path Ahead Following these ethical EHR training best practices ensures the accuracy and reliability of patient data, leading to improved clinical decision-making and patient safety. By maintaining documentation integrity, professionals can confidently provide quality care and reduce the risk of errors. Ethical EHR training further strengthens compliance with legal regulations, safeguarding both the organization as well as the healthcare provider from potential legal liabilities. Moreover, adhering to best practices promotes efficient workflows, enhancing productivity, and streamlining operations. Patient trust and confidence are strengthened as professionals demonstrate their commitment to data security, confidentiality, and ethical conduct. Ultimately, by upholding ethical EHR training standards, professionals contribute to a robust healthcare system by fostering positive patient outcomes, maintaining trust, and supporting the principles of ethical healthcare delivery.

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Spotlight

Abena

Abena is a Danish, family-owned company manufacturing incontinence products, health care products, and baby diapers. Besides our own production in Denmark, Sweden, and France we also supply a wide range of sourced products such as; gloves, body wash, skin care, wound care, food service and paper.

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Vizient- Health systems should expect a nearly 5% spending jump on drugs

Fierce Healthcare | August 06, 2019

Health systems can expect a nearly 5% increase in the cost of their pharmaceutical purchases in 2020, according to a new report. Based on a drug pricing forecast from Vizients pharmacy program, which compiled member participants purchases in hospital and non-acute care settings, pharmaceutical costs will far exceed both inflation and wage growth in 2020, making healthcare less affordable. Other highlights from the forecast include a dramatic change in the approval and introduction of biosimilars into the U.S. market. Nine out of the top 10 drugs (by total spending) among Vizient members in 2020 will be branded biologics, meaning pharmacy and healthcare leaders should start supporting the biosimilars market. Dan Kistner, PharmD, group senior VP of pharmacy solutions for Vizient, noted the changing landscape in the hospital market. “Hospitals are no longer strictly focused on inpatient/acute care services,” Kistner said in a statement. “They are also offering numerous services in the non-acute setting such as outpatient infusions, home infusion, and most importantly specialty pharmacy services. Therefore, the spend profile of our members now includes the new, increasingly specialized medications approved by FDA, which tend to be among the most costly products introduced into practice.”

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Lessons from Bon Secours Mercy Healths supply chain summit

Fiercehealthcare | July 31, 2019

After the recent merger of Mercy Health and Bon Secours to establish one of the largest Catholic health systems in the country, clinicians, infection preventionists and supply chain teams came together for the companys first clinical standardization summit. The one-week April meeting looked to reduce supply spending and to drive improvements in quality and patient safety throughout the newly formed health system. Organized by supply partner Medline at its headquarters in Northfield, Illinois, the summit resulted in $2 million in savings for the organization in the way of reducing overlap and unnecessary products. The meeting was also the first time many of the team members met in person. The workshops tackled standardization across 12 product categories that led to a 44% percent SKU reduction and lowered the number of partner manufacturers from 250 to 48. The team also laid the groundwork for improved clinical programming around infection prevention. FierceHealthcare spoke with Medline Market Director Kyle Hoffmann along with Amy Whitaker, vice president of supply chain integration, and Anne Macy, system director of infection prevention of Bon Secours Mercy Health (BSMH), to learn more about what happened in that first summit and how it paved a way for better patient outcomes.

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HCA Healthcare weighs in on CMS price transparency proposal during earnings call

Fierce Healthcare | July 30, 2019

HCA Healthcare officials said Tuesday that they are still unpacking the Trump administrations plan to push hospitals to post rates negotiated with insurers. Samuel Hazen, CEO of the health system, said on the companys earnings call that HCA has taken significant steps to narrow the delta in pricing between different insurers, which would leave it in a competitive place should the rule go through. He said they will be mulling the implementation of the proposal, though, during the comment period, to ensure it's effective for the patient. "At this point we're focused on the patient and getting the patient the necessary information for them to understand their costs," Hazen said. William Rutherford, executive vice president chief financial officer, said officials "think the HCA system will stand up well in a price transparency." HCA Healthcare earned $783 million in profit in the second quarter of 2019, a decline compared to $820 million in the same quarter in 2018. The health system reported its earnings Tuesday morning at $2.25 per diluted share, and the results did not beat Wall Street's expectations, which projected it to surpass it's Q2 2018 results with $2.49 earnings per share.

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Vizient- Health systems should expect a nearly 5% spending jump on drugs

Fierce Healthcare | August 06, 2019

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Fierce Healthcare | July 30, 2019

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