HHS unveils major revamp to shift health data, AI strategy and policy under ONC

By Emma Beavins - The Officer of the National Coordinator for Health Information Technology (ONC) has been renamed and restructured, the Department of Health and Human Services (HHS) announced this morning. The restructuring will affect technology, cybersecurity, data and artificial intelligence strategy and policy functions. Read Full Article…

HVBA Article Summary

1. Reorganization and Renaming: The Office of the Assistant Secretary for Technology Policy and Office of the National Coordinator for Health Information Technology (ASTP/ONC) has been established, with Micky Tripathi assuming the role of assistant secretary for technology policy in addition to his current title of national coordinator for health IT. This reorganization aims to streamline technology and data policy and strategy across the Department of Health and Human Services (HHS).

2. Expanded Responsibilities and Structure: The new ASTP/ONC will include multiple offices such as the Office of Policy, Office of Technology, Office of Standards, Certification and Analysis, and Office of the Chief Operating Officer. Additionally, the Office of the National Coordinator will now house an Office of the Chief Technology Officer, which will include a chief AI officer, a chief data officer, and a new Office of Digital Services. These offices will oversee HHS-wide data governance, technology, and cybersecurity.

3. Focus on Key Issues and New Leadership Roles: The reorganization responds to the growing importance of cybersecurity, data, and artificial intelligence in healthcare. HHS Secretary Xavier Becerra emphasized the need for agility, accountability, and strategic planning to address these issues. As part of this initiative, the agency is actively seeking senior technology, cybersecurity, and AI executives to fill open positions, with a webinar scheduled for August 1 to discuss these opportunities.

Senators subpoena Steward Health Care CEO Ralph de la Torre to testify publicly

By Michael Kaplan and Sheena Samu - Steward Health Care's CEO Ralph de la Torre has for years avoided publicly responding to accusations that he profited at the expense of patients at the dozens of community hospitals around the country owned by the Dallas-based company. Now, he'll have to face those questions on Capitol Hill after a bipartisan group of senators voted Thursday to launch an investigation into Steward and issued a subpoena to its reclusive chief executive. Read Full Article…

HVBA Article Summary

1. Testimony and Accountability: Dr. Ralph de la Torre, CEO of Steward Health Care, has been called to testify before the Senate Committee on Healthcare, Education, Labor, and Pensions on September 12th. The committee is investigating allegations of financial mismanagement and greed within the company, as highlighted by Senator Bernie Sanders and Senator Edward Markey. This follows reports of financial irregularities and potential legal violations, including fraud and breaches of the Foreign Corrupt Practices Act.

2. Financial Mismanagement and Public Health Impact: Steward Health Care, under de la Torre's leadership, has been accused of siphoning hundreds of millions of dollars from community hospitals, leading to severe public health consequences. Reports from CBS News indicate that Steward's financial practices, including large dividend payouts and the acquisition of luxury items by executives, have left many hospitals underfunded and unable to provide necessary medical care, with instances of unpaid bills leading to shortages of life-saving supplies.

3. Legislative Response and Regulatory Proposals: In response to the Steward Health Care crisis, Senators Markey and Rep. Pramila Jayapal have introduced legislation aimed at regulating financial transactions similar to those carried out by de la Torre and his private equity partners. The proposed regulations seek to protect patient safety and ensure that corporate interests do not override the needs of communities and healthcare providers. The situation has drawn bipartisan concern, emphasizing the need for greater oversight and accountability in the healthcare industry.

CEO of fake Florida health insurer sentenced to 25 years

By Jakob Emerson - A federal court in Illinois has sentenced the owner and CEO of a Hollywood, Fla.-based company to 25 years in prison for selling limited indemnity health plans as if they were full coverage plans using false and deceptive practices. Read Full Article…

HVBA Article Summary

1. Deceptive Practices and Revenue Generation: Simple Health sold misleading insurance policies to over 400,000 people nationwide from May 2012 through November 2018, generating more than $190 million in revenue by falsely presenting limited indemnity plans as comprehensive medical insurance.

2. Legal Conviction: In February, Steven Dorfman, the owner of Simple Health, was convicted by a jury for conspiracy to commit mail and wire fraud. He directed his telemarketing sales agents to deceive consumers into believing that the limited indemnity insurance plans were equivalent to major medical insurance, causing significant financial harm to the victims.

3. FTC Judgment and Consequences: In February, the Federal Trade Commission (FTC) secured a $195 million judgment against Simple Health and Steven Dorfman in a Florida federal court. The judgment included a ban on marketing or selling any healthcare products in the future, the liquidation of all Simple Health assets, and an order for all proceeds to be turned over to the FTC to provide refunds to affected consumers.

Generative AI in healthcare: Adoption trends and what’s next

By Jessica Lamb - The transformative power of generative AI (gen AI) will likely reshape the healthcare industry over time, and organizations are beginning to take action. In our Q1 2024 survey, more than 70 percent of respondents from healthcare organizations—including payers, providers, and healthcare services and technology (HST) groups—say that they are pursuing or have already implemented gen AI capabilities (see sidebar, “Research methodology”). Read Full Article…

HVBA Article Summary

1. Integration and Intentions: The Q1 2024 survey reveals that most US healthcare leaders are either using or testing generative AI (gen AI) tools, with a significant number in the proof-of-concept stage. However, a notable portion remains cautious, with no plans to pursue gen AI or taking a wait-and-see approach.

2. Partner or Pioneer: Among those implementing gen AI, 59% are collaborating with third-party vendors to develop tailored solutions, while 24% plan to build solutions in-house. For those not yet implementing gen AI, 41% intend to purchase off-the-shelf products, primarily due to concerns about risk and technology needs.

3. Hurdles to Scale Up: The primary challenges for scaling up gen AI in healthcare include risk concerns, such as privacy and clinical outcomes, as well as the need for better capabilities, data infrastructure, and proof of value. These issues highlight the industry's limited readiness to deploy and validate gen AI solutions.

CMS: Insurers to make $10.3B in 2023 risk adjustment payments

By Paige Minemyer - The Centers for Medicare & Medicaid Services (CMS) has released new data on risk adjustment payments for 2023. The agency said (PDF) insurers participating on the Affordable Care Act's exchanges will pay $10.3 billion as part of the risk adjustment program. Risk adjustment state transfers as a percent of premiums declined from 2022, according to the report. Read Full Article…

HVBA Article Summary

1. Risk Adjustment Payments and Payers: According to a report from investment bank Stephens, major insurers are facing substantial risk adjustment payments. Aetna is expected to pay the highest fee at around $1.38 billion, followed by Kaiser Permanente at $1.04 billion, Oscar Health at $1.01 billion, UnitedHealthcare at $812 million, and Cigna at $609 million.

2. Beneficiaries of Risk Adjustment Transfers: Not-for-profit Blue Cross Blue Shield plans are projected to be the largest beneficiaries, with an estimated $5.07 billion in risk adjustment transfers. Centene and Molina Healthcare are also expected to benefit, with Centene receiving $20 million and Molina $40 million.

3. Impact on Centene's Financial Strategy: The analysts suggest that Centene's windfall from risk adjustment will be advantageous, potentially allowing the company to reallocate funds towards 2024 risk adjustment accruals or strengthen reserves. This financial boost is expected to help offset margin pressures in Medicare and Medicaid markets, providing a significant EPS tailwind for 2024.

Two Diets Linked to Improved Cognition, Slowed Brain Aging

By Pauline Anderson - An intermittent fasting (IF) diet and a standard healthy living (HL) diet focused on healthy foods both lead to weight loss, reduced insulin resistance (IR), and slowed brain aging in older overweight adults with IR, new research showed. However, neither diet has an effect on Alzheimer's disease (AD) biomarkers. Read Full Article…

HVBA Article Summary

1. Brain Health and Insulin Sensitivity: The study found that both the Intermittent Fasting (IF) and Healthy Lifestyle (HL) diets reduced neuronal insulin resistance (IR) and improved biomarkers of insulin signaling. These diets also lowered brain glucose levels and improved carbohydrate and lipid metabolism, indicating potential benefits for brain health in individuals with IR.

2. Cognitive Function Improvements: Participants on both diets showed improvements in executive function and memory. However, those on the IF diet experienced more robust benefits in specific cognitive tasks, such as strategic planning and task switching. An exploratory analysis suggested that these improvements were more pronounced in women on the IF diet.

3. Weight and BMI Reduction: Both diets led to significant reductions in BMI, weight, and waist circumference, with the IF diet showing a slightly greater decrease in BMI. These results suggest good adherence to the dietary interventions, although the study's short duration and lack of dietary intake data are limitations that may affect the generalizability of the findings.

Do medical errors creep up at hospitals when interns arrive? Yes, but the ‘July effect’ is minimal.

By Helen Getahun-Hawkins - For Dr. Jeremy Faust, July 1 is like New Year’s Day. That’s when thousands of new medical school graduates enter teaching hospitals across the country and provide care to patients as doctors for the first time. Read Full Article…

HVBA Article Summary

1. The July Effect and Hospital Safety: The "July effect" refers to the concern that the influx of new, inexperienced medical interns at teaching hospitals in July might lead to an increase in medical errors and a decrease in patient safety. While there are studies with conflicting findings, teaching hospitals have strong layers of supervision and training, generally ensuring patient safety.

2. Patient Experience and Wait Times: Patients visiting emergency rooms in July might experience longer wait times, particularly for non-urgent cases, as new interns are learning the ropes. However, the thorough evaluations conducted by residents, supervised by attending physicians, can lead to a comprehensive assessment of patients' conditions.

3. Handling the Transition and Mitigating Risks: Teaching hospitals are aware of the potential challenges posed by the arrival of new interns and have implemented rigorous training programs to reduce risks. This intensive preparation helps maintain safety margins and mitigates the effects of the transition on patient care.

More patients opting for joint replacements at younger age

By Mariah Taylor - About 28% of knee and hip replacements are performed on people younger than 55 and the trend is expected to grow, U.S. News & World Report reported July 24. Read Full Article…

HVBA Article Summary

1. Increasing Trend of Joint Replacements in Younger Adults: By 2030, individuals younger than 65 are projected to account for 52% of hip replacements and 62% of total knee replacements. This shift is significant compared to past demographics, with many of these younger patients being former athletes.

2. Changing Perception and Approach to Joint Surgeries: The average age of patients undergoing hip and knee replacements has decreased, with many now in their 50s. This age group is less hesitant to undergo surgery, preferring it over living with chronic pain or relying on medication. Dr. Richard Berger, an orthopedic surgeon, notes that these surgeries are now common outpatient procedures with faster recovery times.

3. Improved Durability and Effectiveness of Joint Replacements: Advances in technology have resulted in artificial joints that are more durable and long-lasting. Only 1% of people under 55 who received a hip replacement needed revision surgery, indicating the effectiveness of current joint replacement techniques and materials. Annually, the U.S. sees approximately 790,000 total knee replacements and 544,000 hip replacements.

Viking to push obesity drug to Phase 3 in bid to reach market faster

By Nicole DeFeudis - Viking Therapeutics is stepping on the gas with its experimental GLP-1/GIP receptor agonist for obesity, forgoing a Phase 2b study and jumping right into Phase 3, the company announced. Read Full Article…

HVBA Article Summary

1. Phase 3 Plans and FDA Meeting: Viking Therapeutics has indicated it plans to meet with the FDA later this year to discuss its Phase 3 plans for the obesity drug VK2735, though details on the trial design are not yet finalized.

2. Potential Market Competitor: Viking's drug VK2735 could potentially compete with existing blockbuster obesity treatments like Eli Lilly’s Zepbound and Novo Nordisk’s Wegovy. The market is becoming increasingly competitive, with multiple companies advancing similar treatments.

3. Clinical Trial Progress and Stock Performance: Viking reported positive topline results for VK2735 in February, leading to a decision to proceed directly to Phase 3 trials. Following this announcement, Viking's stock ($VKTX) rose by 18% in after-hours trading. Additionally, the company is developing an oral version of the drug, which is expected to enter Phase 2 trials later this year.