Payer Roundup—Senate Finance Committee invites PBMs to drug hearing

FierceHealthcare | March 13, 2019

The U.S. Senate Finance Committee, led by Chairman Chuck Grassley and Ranking Member Ron Wyden, invited executives from five pharmacy benefit managers (PBMs) to testify before a committee on drug pricing. The hearing, set for April 3, will be the third in a series of hearings looking at the costs of prescription drugs. Cigna, now the parent company of Express Scripts, CVS, Humana, OptumRx and Prime Therapeutics have been invited to the hearing. As pharmaceutical companies testified on the issue, the committee feels it is only fair to let PBMs talk about their role in lowering prescription drug prices. Grassley and Wyden ask that these companies come prepared to discuss real solutions. “We welcome the opportunity to share with the committee the role of PBMs in advocating on behalf of consumers and plan sponsors to make prescription drugs accessible and affordable,” a spokesperson from the Pharmaceutical Care Management Association (PCMA) told FierceHealthcare.

Spotlight

The keys to success in year one of the Medicare Pioneer ACO for Monarch HealthCare were engaging vulnerable patients in the ACO and developing a strategy to align non-contracted physicians. Monarch HealthCare was the third most successful pioneer ACO in terms of cost savings and the second most successful in beating the trend.


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FUTURE OF HEALTHCARE,MEDICAL DEVICES

Healthcare Under Cyberattack: Unprotected Medical IoT Devices Threaten Patient Care

Capterra | November 30, 2022

The rising adoption of connected medical devices is accelerating cyberattacks, according to Capterra’s new Medical IoT Survey of healthcare IT professionals. The survey also reveals that 67% of healthcare cyberattacks impact patient data and nearly half impact patient care, an indication that rising security risks in the industry are leading to severe consequences in patient outcomes and privacy. The medical internet of things is helping to make healthcare more convenient, efficient, and patient-centric. However, connected devices with IoT sensors often have unprotected security vulnerabilities that endanger healthcare facilities, and even patients. In fact, medical practices with more than 70% of their devices connected are 24% more likely to experience a cyberattack than practices with 50% or fewer connected devices. “As a healthcare organization connects more medical devices to its network, its attack surface expands. Connected medical devices often go unmonitored for security vulnerabilities, and because they run on a wide array of software and hardware platforms, it’s difficult to monitor with a single tool. This means that many connected medical devices are left wide open to cyberattacks.” Zach Capers, senior security analyst at Capterra More than half of healthcare IT staff rate the cybersecurity threat level in the industry as high or extreme, yet many healthcare organizations are not taking the necessary steps to protect medical IoT devices. Alarmingly, 57% do not always change the default username and password for each new connected medical device that is put into use. Additionally, 82% run connected medical devices on old Windows systems. If a security vulnerability is discovered, organizations should patch the device or update its firmware as soon as possible. Unfortunately, 68% of healthcare organizations don’t always update connected devices when a patch is available. However, vulnerabilities and associated patches aren’t always well publicized, which means healthcare IT staff must stay up-to-date on emerging threats to medical IoT devices. Medical IoT security requires proactive and ongoing vigilance. Healthcare practices should conduct routine vulnerability assessments before connecting medical devices to their IT network. They should also keep an up-to-date and accurate inventory of all connected devices plus associated software and firmware, and use software to monitor these devices. Read the full report on Capterra.com to learn more about best practices for healthcare organizations to strengthen security for their medical IoT devices. About Capterra Capterra is the leading software reviews and selection platform that connects businesses to the right technology. Compare software, read and leave reviews, and access objective insights that empower business growth.

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MEDICAL DEVICES, HEALTHCARE ANALYTICS

The Garage enters strategic partnership with Morris Heights Health Center in an effort to change healthcare in underserved Bronx, NY

Garage and Morris Heights Health Center (MHHC) | December 05, 2022

Population health management platform company, the Garage, announced that it is joining forces with federally qualified health center, Morris Heights Health Center (MHHC). The Bronx-based MHHC serves over 50,000 patients, and its mission is to be the vanguard for quality, affordable, and accessible health care for all. MHHC will be utilizing the Garage’s proven population health management platform, Bridge, for empowering better care in the community. The SaaS platform connects providers, care teams and enables real-time patient information exchange, facilitates referral management, secure messaging, patient tracking and communication, clinical data management, clinical integration, clinical intelligence, and clinical analytics. “We are excited to partner with the Garage. We needed a solution that would help us better serve our patients and prepare us for the opportunities ahead in value-based care. Their proven credentials along with the depth of their platform made this decision a no-brainer.” Mari Millet, President and CEO of MHHC MHHC’s utilization of Bridge will start with a focus in care management for all of its patients and will be another implementation of the Garage’s Digital-First, Data-First approach, which focuses on the Quintuple Aim – Lower Costs of Care, Better Care for the Patient, Improved Health of Communities, Sustainable Service Model for Care Teams, and Equitable Access to Care for All. “Our mission to change healthcare for good…one community at a time is realized by partnerships like this,” said Pranam Ben, Founder and CEO of the Garage. “MHHC’s commitment to their patients presents a great opportunity for us to architect a data driven, platform-based, collaborative care model for the Bronx community.” About the Garage Based in Orlando, Florida, the Garage is a population health management technology company dedicated to changing healthcare for good…one community at a time. The company works with more than 140+ healthcare organizations and 19,500+ providers across 34 states. Through its collaborative population health management platform, Bridge, the Garage touches more than 15 million patient lives. About Morris Heights Health Center MHHC is a non-profit organization funded by federal, state, and foundation grants as well as private and corporate donors. They serve more than 50,000 patients annually and provide a wide range of primary, specialty, dental, mental health, educational, and social services at thirteen locations throughout the Bronx.

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FUTURE OF HEALTHCARE, MEDICAL DEVICES

Catalyst Solutions Announces Third-Party Administration White Paper Publication

Catalyst Solutions | December 22, 2022

Catalyst Solutions announces the publication of the white paper, Third Party Administration for Healthcare Payers. This white paper reviews the unique needs that self-funded and fully-insured plans might have for Third Party Administration as well as, the services and benefits TPAs provide. As an industry, healthcare continues to experience constant change. The landscape is dynamic, and new challenges are on the horizon. Mergers, acquisitions, and partnerships are occurring at an unprecedented rate - and the government continues to introduce mandates to which the healthcare plan must adhere. These factors continue to add demands on plans that are already facing budgetary and resource constraints. "To manage these challenges healthcare payers are increasingly outsourcing business processes to Third Party Administrators. Just like in organizations, outsourcing allows them to focus on what they do best, which is: improving the healthcare outcomes of their membership." Scott Martin, President of Catalyst Solutions TPAs deliver administrative support to self-funded businesses and fully-insured healthcare plans. Both are increasingly outsourcing day-to-day operational services to a TPA, which is driving significant cost savings and reducing the administrative burden. Catalyst Solutions provides a full suite of TPA services. Its team of fully-trained, US-based employees can deliver the operational and technology functions required by a healthcare plan or self-funded business. Catalyst seeks to maximize the performance of healthcare plans by taking a holistic view of people, process, and technology. "Catalyst engages plans at a strategic level," Scott Martin said, "aligning our outsourcing services to our customer's business goals. We use our industry expertise to anticipate our customers' long-term needs. Our services don't end with outsourcing – we become trusted advisors in helping our customers achieve a better future." About Catalyst Solutions Catalyst Solutions has an extensive history of exclusively serving the payer industry. With 20+ years of deep industry expertise, Catalyst provides outsourced BPO, IT, and consulting services. As a diversity-certified, woman-owned company based in the U.S., our mission is to help insurance payers drive down costs, optimize revenue, and most importantly, improve member healthcare outcomes. We deliver comprehensive and flexible solutions that meet the unique needs of payers, and we are committed to exceeding customer expectations by providing unmatched, white-glove service. We are passionate about making positive and measurable change on behalf of the clients we serve and the communities in which we live.

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DIGITAL HEALTHCARE, MEDICAL DEVICES

Swisslog Healthcare Elevates Cory Kwarta to CEO

Swisslog Healthcare | December 19, 2022

Swisslog Healthcare, a leading supplier in healthcare technology solutions of both medication management and transport automation, has appointed Cory Kwarta as its CEO. Kwarta, who was appointed as CEO of the Swisslog Healthcare – TransLogic division earlier this year, is now entrusted to oversee the global organization, guiding both the company’s TransLogic® and Medication Management divisions. “Since I started at Swisslog Healthcare, my goal has always been to help improve efficiencies in the healthcare industry. As CEO of the company, I will remain dedicated to our organization’s commitment of helping our customers and partners provide the highest quality healthcare.” Cory Kwarta Cory Kwarta was also recently named as a member of Swisslog Healthcare’s Board of Directors. The move came as a result of Kwarta’s recent prior promotion to CEO of Swisslog Healthcare – TransLogic and his 15 years of service with the organization. Kwarta has a bachelor’s degree in systems engineering from the United States Military Academy at West Point and a master’s degree in business administration from the University of Denver. Swisslog Healthcare’s TransLogic division works with healthcare facilities to develop custom-designed pneumatic tube systems which automate their needs to transport materials from station to station. The Medication Management division of Swisslog Healthcare assists healthcare facilities with automating and managing the pharmaceutical workflow, including preparation, patient-specific dosing, delivery, and storage. Both divisions deliver operational cost reduction by enabling the redeployment of personnel to patient-facing activities. About Swisslog Healthcare Swisslog Healthcare provides integrated medication supply chain solutions to hospitals and health systems to assist providers in treating patients across the continuum of care. Integrating transport and pharmacy automation, value-added services, and intelligent software, Swisslog Healthcare enables healthcare providers to respond to patient’s needs quickly and with greater accuracy. The company minimizes many sources of operational waste, so providers achieve higher levels of productivity to impact the well-being of patients in positive ways.

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Spotlight

The keys to success in year one of the Medicare Pioneer ACO for Monarch HealthCare were engaging vulnerable patients in the ACO and developing a strategy to align non-contracted physicians. Monarch HealthCare was the third most successful pioneer ACO in terms of cost savings and the second most successful in beating the trend.

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