Analysis: Pulling back curtain on hospital prices adds new wrinkle in cost control

Healthcare Finance | January 28, 2019

As President Donald Trump was fighting with Congress over the shutdown and funding for a border wall, his administration implemented a new rule that could be a game changer for health care. Starting this month, hospitals must publicly reveal the contents of their master price lists -- called "chargemasters" -- online. These are the prices that most patients never notice because their insurers negotiate them down or they appear buried as line items on hospital bills. What has long been shrouded in darkness is now being thrown into the light. For the moment, these lists won't seem very useful to the average patient -- and they have been criticized for that reason. They are often hundreds of pages long, filled with medical codes and abbreviations. Each document is an overwhelming compendium listing a rack rate for every little item a hospital dispenses and every service it performs: a blood test for anemia.

Spotlight

Children of women prescribed an opioid painkiller face a nearly 2.5-fold higher risk of being hospitalized for opioid overdose than children whose mothers don’t receive these drugs, according to a new study from the Institute for Clinical Evaluative Sciences (ICES) and The Hospital for Sick Children (SickKids). The dramatic increase in the prescribing of opioids such as codeine and oxycodone over the past two decades in North America has been associated with a marked increase in fatal overdoses.


Other News
HEALTH TECHNOLOGY

Valtruis Brings Advanced Healthcare Data Analytics Capabilities Into Its Portfolio With Ursa Health Partnership

Ursa Health and Valtruis | June 28, 2022

Valtruis, a WCAS company, has entered a strategic partnership with Ursa Health, a healthcare data analytics company that brings a paradigm-breaking approach to how healthcare organizations use their data to learn, make decisions, and innovate Valtruis portfolio companies Cricket Health and Wayspring are already experiencing quantifiable advances in their data analysis and management capabilities through both the Ursa Studio no-code analytics development platform and the unusually productive training, support, and consultative relationships they have formed with Ursa Health’s team of healthcare IT and data analytics experts. “Building on the investments made in our first year – with Cricket Health, Wayspring, U.S. Medical Management (USMM) and Oncology Care Partners – we are moving quickly and strategically to realize our foundational commitment,” said Valtruis Managing Director Karey Witty. “That commitment is to accelerate the adoption of value-based care through investments in and collaboration with companies and entrepreneurs that share the vision, talent, and innovative strategies to make value-based care a reality. Ursa Health is one of those companies.” “We bring scalable innovation to healthcare. Companies driving toward meaningful strategic innovation need their data to provide richer, more nuanced answers than healthcare as an industry has historically delivered – and they need these insights at the speed of business. Ursa Studio is a technology that unlocks a fresh approach to developing trusted information. On the technical level, the platform shifts IT team time from the labor of debugging code and managing data plumbing, opening up their capacity to answer additional business questions. On the human level, the platform enables rapid iteration and collaboration between the producers and consumers of analytics, bringing teams to a successful endpoint more quickly. As a result, organizations gain the self-service capacity to fill their information gaps and guide their innovations more efficiently and effectively.” Ursa Health CEO and Co-Founder Robin Clarke, MD Early-phase successes from Valtruis’ partner companies attest to the value, intelligence, and flexibility of the Ursa Health technology and analytics approach. Adam Dunning, Chief Information and Analytics Officer at Wayspring, stated: “We needed a solution to fast-track the development of our SUD Home offering. Working with Ursa Studio, allowed us to accelerate the building of foundational data analytics structures. Our clients and staff will see notable returns as we continue to master the technology offering developed by Ursa Health.” About Valtruis Valtruis, a WCAS company, provides a unique platform that invests in and partners with disruptive leaders whose mission is to align, and transform healthcare through what is truly value-based care. Founded on a commitment to accelerate meaningful change, Valtruis brings the functional expertise, access to capital, and an expansive network that advance our partners’ evolution from early-stage development to industry-leading enterprises. Together, Valtruis and its partner companies will break through the systemic barriers in the healthcare industry to reduce costs, expand access, increase quality, and radically improve the patient experience. About Ursa Health Ursa Health is transforming analytics so innovators can transform healthcare. Our analytics development platform, Ursa Studio, combines no-code technology with healthcare-specific content, enabling health plans, providers, digital health companies, and others to take a Buy Your Build™ approach to their analytics infrastructure. With the structured adaptability of Ursa Studio, organizations can make full use of their rich data resources to accelerate growth.

Read More

FUTURE OF HEALTHCARE

Trinity Health to Acquire CommonSpirit Health's Share of MercyOne Health System Become Sole Parent

Trinity Health | April 20, 2022

Trinity Health and CommonSpirit Health announced they have signed an agreement for Trinity Health to acquire all facilities and assets of MercyOne, a regional health system based in Iowa. Since 1998, MercyOne has operated under a joint operating agreement between not-for-profit Catholic health care organizations Trinity Health and Catholic Health Initiatives, which is now CommonSpirit. MercyOne is a leading health system in Iowa and serves more than 3.3 million patients each year. The system includes 16 medical centers, 27 affiliate organizations and more than 420 care sites offering a range of health and wellness services, including provider services and urgent care, and more than 20,000 colleagues including 2,000 of the state's most talented doctors and providers. "True to our shared Catholic mission, our goal is to provide high-quality, compassionate care with the best patient/member experience possible. We will accomplish that goal through a holistic approach, with a range of health services and technologies that are fully connected and coordinated. This agreement creates a fully integrated MercyOne to care for more people in a unified way." Mike Slubowski, president and chief executive officer at Trinity Health After months of analysis and due diligence, Trinity Health and CommonSpirit determined a sole parent is the best path forward for MercyOne and for the communities it serves. Trinity Health, a national health system spanning 25 states, will bring unified strategies and operations to MercyOne's care sites, including one set of system services. As an example, MercyOne will transition to Trinity Health's common platforms, including a single electronic health record (EHR), ultimately allowing patients to easily manage their care across all MercyOne services and facilities. The result is a more convenient and consistent care experience for MercyOne's communities. "After two decades of successful collaboration, we are immensely proud of our partnership with Trinity Health and our efforts to advance health care statewide," said Marvin O'Quinn, president and chief operating officer at CommonSpirit Health. "While the current structure has been instrumental in growing our health care services in Iowa, we believe this decision is ultimately what is best for our patients, colleagues, and our communities." "We strongly believe this transition to become a full member of the Trinity Health family will result in a stronger, more cohesive health system better able to offer a convenient and personalized circle of care for all we serve," said Bob Ritz, president and chief executive officer at MercyOne. "We are delighted to have the agreement in place as we plan for the future of our mission. We are grateful to CommonSpirit for more than 20 years of partnership." Trinity Health and CommonSpirit will now plan for integration, complete regulatory filings, and take other steps necessary to finalize the transaction, which is expected to be completed summer 2022. This process will be seamless for the communities MercyOne serves, and patients can continue to expect the same compassionate care they have always received. About Trinity Health Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, Trinity Health's network of care includes 88 hospitals, 131 continuing care locations, the second largest PACE program in the country, 125 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, its annual operating revenue is $20.2 billion with $1.2 billion returned to its communities in the form of charity care and other community benefit programs. For more information, visit www.trinity-health.org or follow us on LinkedIn, Facebook or Twitter. About CommonSpirit Health CommonSpirit Health is a nonprofit, Catholic health system dedicated to advancing health for all people. It was created in February 2019 by Catholic Health Initiatives and Dignity Health. With its national office in Chicago and a team of over 150,000 employees and 25,000 physicians and advanced practice clinicians, CommonSpirit operates 140 hospitals and more than 1,500 care sites across 21 states. In FY 2021, CommonSpirit had revenues of $33.3 billion and provided $5.1 billion in charity care, community benefit, and unreimbursed government programs. Learn more at www.commonspirit.org. About MercyOne MercyOne is a connected system of health care facilities and services dedicated to helping people and communities live their best life. MercyOne's care providers and staff make health the highest priority. The system's clinics, medical centers, hospitals and affiliates are located throughout the state of Iowa and beyond. Headquartered in central Iowa, MercyOne was founded in 1998 through a collaboration between Catholic Health Initiatives, now CommonSpirit Health, and Trinity Health - two of the country's foremost, not-for-profit Catholic health organizations.

Read More

FUTURE OF HEALTHCARE

NextGen Healthcare Partners with Circuit Clinical to Bolster Diversity in Clinical Trials by Extending Access to Underserved Communities

NextGen Healthcare, Inc. | May 05, 2022

NextGen Healthcare, Inc. a leading provider of innovative, cloud-based healthcare technology solutions, announced a partnership with Circuit Clinical to bring clinical trial access to patients of Federally Qualified Health Centers through over 14,000 providers that utilize NextGen Healthcare solutions. Historically, these underserved communities have not had easy access to participate in transformative clinical research that can provide enhanced treatment options. Such research-as-care can also improve health outcomes and offers revenue generation for the clinics that participate. NextGen Healthcare’s innovative collaboration with Circuit Clinical, whose mission is to transform how patients find and choose clinical trials by bringing them to the doctors they know and trust, will improve the participation of diverse patients in clinical trials and provide greater health equity by facilitating access to the underserved. “This partnership underscores NextGen Healthcare’s commitment to FQHCs and highlights our commitment to serving diverse patient populations. NextGen Healthcare’s technology is empowering providers to build healthier communities. Our work with Circuit Clinical is a milestone that provides real impact for our clients and their patients, and delivers on our pledge to facilitate better healthcare outcomes for all.” Srinivas (Sri) Velamoor, chief growth and strategy officer at NextGen Healthcare The collaboration contributes to the vision of the NextGen® Community Health Collaborative, a first-of-its-kind initiative announced late last year that offers data benchmarking, comparative analytics and reporting services, plus a forum for members to connect and share best practices to advance the mission of community health and health equity among underserved populations. NextGen Healthcare-powered practices, in conjunction with Circuit Clinical, will now be able to offer clinical trial patient recruitment, referral and enrollment services, eliminating obstacles to such care. Furthermore, participation provides tangible benefits to participants, including extra care visits without co-pays, therapeutic improvement on a better regimen, and patient stipends. “Our partnership with NextGen Healthcare will create a comprehensive solution for improving access to clinical trials for diverse communities across the country,” said Dr. Irfan Khan, founder and chief executive officer of Circuit Clinical. “Combining NextGen Healthcare’s comprehensive data insights and national reach with Circuit Clinical’s expert ecosystem offers pharmaceutical, biotech and vaccine companies a groundbreaking opportunity for accelerating therapeutic development and improving diversity in clinical trials.” In April, the Food & Drug Administration (FDA) issued updated guidance to provide recommendations to those developing medical products on the approach for developing a Race and Ethnicity Diversity Plan to help enroll adequate numbers of participants in clinical trials from underrepresented racial and ethnic populations. Adequate representation in clinical trials helps ensure that the data generated reflects the racial and ethnic diversity of the intended use population and may potentially identify safety or efficacy outcomes, the FDA said. About NextGen Healthcare, Inc. NextGen Healthcare, Inc. is a leading provider of innovative healthcare technology solutions. We are reimagining ambulatory healthcare with award-winning solutions that enable high-performing practices to create healthier communities. We partner with medical, behavioral and dental providers in their journey toward whole-person health and value-based care. Our highly integrated, intelligent and interoperable solutions go beyond EHR and Practice Management to increase clinical quality and productivity, enrich the patient experience and drive superior financial performance. We are on a quest to achieve better healthcare outcomes for all. About Circuit Clinical Circuit Clinical®, one of the largest integrated research organizations in the USA, is dedicated to empowering patients to choose clinical research as a care option. Circuit Clinical® is committed to transforming the way physicians and their patients find, choose, and participate in clinical research. The company delivers clinical research services and an award-winning patient engagement platform, trialjourney.com.

Read More

FUTURE OF HEALTHCARE

OmniLife Partners With Redox to Add Patient Referral Management Tool to Its End-to-End Communication Platform for Transplant Hospitals.

OmniLife | March 25, 2022

OmniLife, a health technology communication and collaboration platform, has partnered with Redox, the industry-leading electronic health record integration and healthcare interoperability platform, to create a new integrated patient management tool as part of its overarching platform that provides end-to-end communication solutions for transplant hospitals. The new patient modules, OmniReferral and PatientStatus, will allow transplant centers to easily review new referrals and share updates on patient status to providers and allows transplant centers to customize their own digital forms to make it easier for providers to refer and then monitor the activity and status of transplant patients. The tool also integrates into the EHR patient checklists and allows centers using EHRs to easily share patient status updates with referring providers. OmniReferral and PatientStatus is built to be organ agnostic, allowing centers to use the tool across all organ departments and with any referring provider. OmniLife has been leading efforts to improve communication, decision making, and secure information exchange between all stakeholders in the greater allotransplant ecosystem. Additionally, OmniLife is currently participating in a clinical trial funded by the National Institutes of Health (NIH) for a Small Business Innovation Research (SBIR) which includes notable centers such as UPMC Children’s Hospital of Pittsburgh, Loma Linda University Transplant Institute, and Stanford Health Care Transplant Program. About OmniLife OmniLife is a certified Benefit Corporation focused on maximizing the gift of life for purposes of transplantation and research. OmniLife is the only end-to-end communication and clinical workflow software platform that is built specifically to create a more connected and collaborative allotransplant ecosystem.

Read More

Spotlight

Children of women prescribed an opioid painkiller face a nearly 2.5-fold higher risk of being hospitalized for opioid overdose than children whose mothers don’t receive these drugs, according to a new study from the Institute for Clinical Evaluative Sciences (ICES) and The Hospital for Sick Children (SickKids). The dramatic increase in the prescribing of opioids such as codeine and oxycodone over the past two decades in North America has been associated with a marked increase in fatal overdoses.

Resources