Feds warn of 'double extortion' hackers targeting healthcare

By Giles Bruce - Federal authorities are warning of a new ransomware gang that has already claimed at least one healthcare victim in the U.S. Read Full Article…

HVBA Article Summary

1. Tactics and Double Extortion: Trinity ransomware employs various tactics, including phishing emails, malicious websites, and exploiting software vulnerabilities to infiltrate organizations. It utilizes a "double extortion" strategy, where sensitive data is exfiltrated before encryption, with threats to publish the data if the ransom is not paid.

2. Targeted Victims and Demands: The ransomware has notably impacted the U.S. healthcare sector, with a reported victim being a gastroenterology services provider from which Trinity claimed to have stolen 330 gigabytes of data. The gang demands payment in cryptocurrency and is believed to be linked to other ransomware groups, such as 2023Lock and Venus.

3. Lack of Decryption Tools and Recommended Mitigations: Currently, there are no known decryption tools available for Trinity ransomware, leaving victims with limited options for recovery. Authorities advise healthcare organizations to adopt mitigation measures, including implementing a data recovery plan, network segmentation, and maintaining offline data backups to enhance their cybersecurity posture.

Does Higher Spending On Primary Care Lead To Lower Total Health Care Spending?

By Gary Swan, Mary Jo Condon, Wayne Altman, Russell S. Phillips, Zirui Song, Corinne Lewis, Sarah Shaffer, and Rik Ganguly - High-quality primary care is the foundation of a high-functioning health care system. It ensures patients have access to essential services, prevents emergency department visits and hospital admissions, leads to better health outcomes, and improves quality of care and equity. Read Full Article…

HVBA Article Summary

1. Importance of Long-Term Relationships: High-quality primary care relies on the establishment of long-term relationships between patients and clinicians, fostering trust that allows for more effective and cohesive healthcare management, rather than reactive and fragmented approaches often seen in the U.S. healthcare system.

2. Investment Challenges and State Initiatives: Despite the clear benefits of primary care, the sector faces significant challenges due to chronic underinvestment, low reimbursement rates, and administrative burdens. In response, over a third of states are initiating efforts to increase funding for primary care, although these efforts often encounter legislative obstacles and scrutiny.

3. Evidence of Value and Future Directions: Research consistently indicates that increased investment in primary care correlates with improved quality of care, reduced hospital services, and enhanced patient experiences. However, more evidence is needed to link higher spending directly to overall cost savings, prompting ongoing research into effective investment strategies and payment models that maximize the benefits of primary care.

US spent $99B on cancer drugs in 2023: 5 things to know

By Elizabeth Gregerson - The U.S. spent $99 billion on both oral and clinician-administered cancer therapies in 2023, according to a report published in April by analytics firm IQVIA. As cancer drug prices continue to increase, spending is projected to grow. Read Full Article…

HVBA Article Summary

1. Significant Market Share: In 2023, U.S. spending on cancer drugs reached $99 billion, accounting for 45% of the total global expenditure on cancer medications.

2. Projected Growth: This spending is anticipated to double by 2028, rising to $180 billion, primarily driven by high launch prices for new therapies and ongoing price hikes for existing treatments.

3. Price Increase vs. Outcomes: Despite a dramatic average increase of 94% in cancer drug prices from 2005 to 2023, a study found no correlation between these price hikes and improvements in patient survival rates.

Employer health care premiums hit $25K in 2024: KFF

By Lynn Cavanaugh - Is inflation really easing? Well, for health care, not so much. This marks the second year in a row that employer-sponsored health insurance premiums are up 7% to reach an average of $25,572 annually, according to KFF's annual survey, 2024 KFF Employer Health Benefit Survey. Read Full Article…  ^{_{(Subscription required)}}

HVBA Article Summary

1. Significant Premium Increases: In 2024, premiums for employer-sponsored health coverage rose by 7%, marking the largest increase since 2011. Employees contributed an average of $6,296 toward family coverage, while employers covered $19,276.

2. Coverage Trends: The survey revealed that only 18% of large employers (with at least 200 employees) provide coverage for GLP-1 drugs for weight loss, and approximately 27% cover in-vitro fertilization (IVF). Additionally, 8% of large employers do not cover legally provided abortions, with another 18% offering limited coverage.

3. Focus on Mental Health and Spousal Benefits: About 48% of firms with at least 200 workers reported increasing mental health counseling resources, while 24% of firms offering spousal health benefits impose higher premiums or restrictions if the spouse has alternative coverage.

Surgical Center Wins Stunning $421 Million Verdict Against Blue Cross

By Randy Dotinga - In a stunning verdict against Blue Cross and Blue Shield of Louisiana, a New Orleans jury has awarded $421 million in damages to a surgery center over the insurer's alleged failure to fully pay out-of-network charges. Read Full Article… 

HVBA Article Summary

1. Legal Implications of the Verdict: The September 20 verdict in favor of the St. Charles Surgical Hospital and Center for Restorative Breast Surgery may empower out-of-network providers by potentially requiring insurers to pay higher rates for authorized procedures, challenging the traditional dynamics of provider-insurer relationships.

2. Contentions Over Payment Practices: The lawsuit alleges that Blue Cross and Blue Shield of Louisiana failed to adequately reimburse the surgery center for approximately 7,000 out-of-network procedures, claiming the insurer engaged in practices of slow, low, or no payments over an eight-year period. Blue Cross contends it has no contractual obligation to pay for services from out-of-network providers.

3. Market Dynamics and Provider Decisions: Experts point out that without a contract, out-of-network providers can set their own charges, leading to unpredictable billing and payment scenarios. Questions arise about the surgery center’s decision to continue accepting Blue Cross patients despite knowing the insurer's payment practices, suggesting that a return to upfront payment models might have been a more straightforward approach.

Improve your employee benefits: A Q&A with Barry Fitzpatrick

By Lily Peterson - In today's competitive job market, employers are on a constant pursuit to attract top talent who can support their clients and drive their organization's success. Offering compelling employee benefits has become crucial in both attracting and retaining valuable staff. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Individualization of Benefits: Employers should focus on creating a personalized benefits experience that addresses the unique needs and preferences of their employees. This can be achieved by offering various health plan designs, coverage tiers, and voluntary insurance options. Engaging in open dialogue with employees will help identify which benefits resonate most and uncover new opportunities for enhancement.

2. Strategic Affordability Improvements: To make health insurance more affordable, employers need a well-thought-out, incremental strategy that involves reviewing and refining medical contracts. This includes analyzing administrative fees, network access costs, and shared savings fees. Such a comprehensive review can lead to significant cost reductions and improved affordability for employees.

3. Effective Communication Strategies: Successful employee benefits programs depend on robust communication tailored to employees' preferences. Employers should solicit feedback to understand the best communication methods and leverage technology to track engagement metrics. A mix of traditional and innovative communication approaches will ensure that employees receive and understand their benefits information effectively.

80% of EDs underprepared to treat children: 5 study takeaways

By Elizabeth Gregerson - Approximately 80% of emergency departments were found to be underprepared for treating pediatric patients, according to a study published Oct. 7 in Health Affairs. Read Full Article…

HVBA Article Summary

1. Study Scope and Representation: The evaluation included 747 emergency departments from various states, including Arizona, California, and New York, ensuring a diverse mix of sizes and demographics that reflect the broader U.S. healthcare landscape.

2. Scoring System and Outcomes: Emergency departments were rated on a scale of 0 to 100, with scores of 88 or higher indicating a "highly ready" status for treating children. Notably, about 7.9 million children were treated in the 80% of departments that scored below this threshold.

3. Impact on Pediatric Mortality: The study found that enhancing the preparedness of emergency departments to treat pediatric patients could potentially reduce young patient deaths by 42%. Currently, the mortality rate for children in emergency settings stands at 78.03 deaths per 100,000 children.