FDA Approves First Fecal Microbiota Pill for Recurrent C. diff Infection
April 28th 2023CDI is a leading cause of infections acquired in healthcare settings, including hospitals and nursing homes. After recovering, individuals may get the infection again, and the risk of recurrence increases with each infection.
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The Rollercoaster Ride of Healthcare Spending Has Increased Back to Pre-Pandemic Levels
April 26th 2023The average annual healthcare spending for people with employer-sponsored insurance spending increased to $6,467 in 2021 from $5,630 in 2020. Per person healthcare spending increased 15% in 2021, following a 4% decrease in 2020.
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Hospital Group Assails AHIP’s Drug Price Report
April 25th 2023The American Hospital Association said the health insurers' report on drug prices, which highlights the higher prices charged by hospitals, is “a blatant attempt to deflect from the obvious — insurance companies continue to raise premiums for their enrollees and employer clients while pocketing billions in profit.”
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Poverty Is the Fourth Leading Cause of Death in the United States, Study Finds
April 23rd 2023In 2019 there were roughly 183,000 deaths associated with poverty in the U.S. among people 15 years and older. This is a significant result as the data is from the year prior to the COVID-19 pandemic when death rates skyrocketed.
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Express Scripts Expands Independent Pharmacy in Rural Healthcare
April 20th 2023The expansion offers increased reimbursement opportunities and additional care services to rural independent pharmacies. In addition, it creates an Independent Pharmacy Advisory Committee to expand the role of rural, suburban and urban pharmacies in the healthcare system.
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What Fraud and Abuse Has Cost Healthcare, How & How Much AI Can Save the Industry From It
April 19th 2023In this final part of a two-part video series, Clay Wilemon, CEO of 4L Data Intelligence, shared how much in cost that fraud, waste and abuse has affected healthcare due to issues like overpayment; and how leveraging your artificial intelligence can help solve fraudulent issues. Clay added how much the industry can save using these solutions.
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CVS Health Keeps Getting Bigger and Bigger
April 17th 2023Aetna, Signify Health and now Oak Street Health. Some see advantages to CVS acquiring a primary care provider — for U.S. healthcare as well as CVS. Others see risks of even more consolidation in the healthcare sector and perhaps a financial hit to CVS because of Oak Street’s net losses.
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New Express Scripts Programs Aim to Boost Affordability, Transparency
April 13th 2023Through Express Scripts’ new Copay Assurance plan, consumers will have lower out-of-pocket costs because of caps on prescription drugs: $5 for generics, $25 for preferred brand drugs, and $45 for preferred specialty brand drugs.
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David Calabrese of OptumRx Talks New Role, Market Insulin Prices and Other Topics 'On His Mind'
April 13th 2023In this month’s episode of the "What's On Your Mind podcast," Peter Wehrwein, managing editor of MHE connects with the now Chief Clinical Officer of OptumRx Integrated Pharmacies, David Calabrese. In this conversation, David touches on his transition in January as OptumRx’s former chief pharmacy officer and market president of health plans and PBMs to his new role as Chief Clinical Officer where he now focuses more on things such as specialty pharmacy to home delivery — with an overall goal of creating whole-patient care. Throughout the conversation, Calabrese also touched on the market’s hot topic of insulin prices and behavioral health services within the OptumRx community, among other topics.
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How Adopting AI Combats Fraud, Waste and Abuse Caused by Overpayment
April 7th 2023Briana Contreras, an editor with Managed Healthcare Executive, had a chat with Clay Wilemon, CEO of 4L Data Intelligence, in this month’s episode of Tuning In to the C-Suite. The discussion was on the subject of fraud, waste, and abuse within the healthcare industry and how much of it stems from issues like overpayment. Clay addressed how the adoption of artificial intelligence can help combat fraud, waste and abuse and shared how much the industry can save by using AI.
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Type of Delivery Does Not Affect How a Baby's Microbiome Is Developed, Study Finds
April 5th 2023Over 600 pregnant women and their newborns were analyzed to test the long-time assumption that has resulted in inconsistent data collected in past studies. For more clear results, researchers collected and evaluated pre-delivery maternal vaginal swabs and infant stool samples at 10-days and 3-months of life.
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