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Morning Briefing

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Thursday, Sep 16 2021

Full Issue

Aetna Will Update Infertility Coverage After LGBTQ Bias Lawsuit

Just two days after a woman sued Aetna, alleging LGBTQ people had to pay tens of thousands for infertility treatment when heterosexual people didn't, the company said it will change its policy. DirectTrust, Atropos Health, Banner Health and more are also in the news.

Aetna will update its coverage rules for infertility treatment just two days after a woman sued the insurer over its policy that forced LGBTQ individuals to pay tens of thousands of dollars out of pocket for procedures that it offered to heterosexual people with no cost-sharing. The insurer, which is owned by CVS Health, acknowledged it improperly denied coverage to Emma Goidel, a 31-year-old covered under an Aetna plan for Columbia University students who filed the proposed class-action against the company Monday. (Tepper, 9/15)

In other health care industry news 鈥

DirectTrust is creating a body to establish standards that healthcare organizations and human services providers can use when exchanging data on social determinants of health, the trade organization announced Wednesday. Healthcare providers are increasingly focused on addressing the ways social determinants of health such as food, transportation and financial insecurity can affect patients' health. While screening for social determinants has become more common among healthcare providers, they've run into roadblocks when setting up programs to actually refer patients to needed services. That's partly because many human services providers don't use software programs that easily exchange referrals and other data with healthcare organizations. (Kim Cohen, 9/15)

A company is launching out of Stanford University on Wednesday to tackle one of the most enduring challenges of digitized medicine: How do you apply data from past patients to inform the care of new ones? The company, named Atropos Health, is seeking to commercialize a consultation service designed to use mountains of existing data to quickly answer a wide range of pressing questions, such as which drug is most effective for certain kinds of cancer patients, or when antibiotics can be safely discontinued in the treatment of a particular infection. (Ross, 9/15)

A catalyzing new review found virtually no research into ethics, security, and data rights of digital health measures 鈥 a worrying trifecta of blind spots for a field and an industry that will need the public鈥檚 trust to make a difference in health outcomes. The promise of digital health measures like movement and heart rate have gained prominence during the pandemic, as doctor鈥檚 appointments shifted online and clinical trials were forced to go remote. Research into these measures is being steered both by academia and industry, including the tech titans whose wearable devices can drive the bulk of data collection. (Palmer, 9/15)

Banner Health named Amy Perry president and chief operating officer on Wednesday, with the former Atlantic Health System executive preparing to assume the new role November 1. Perry currently serves as head of Morristown, New Jersey-based Atlantic Health's hospital division and executive vice president of care delivery, where she oversees operations across the company's more than 400 sites of care. Those include medical centers, home health, hospice, adult day care services, along with the organization's information technology and innovation efforts. She will succeed Banner Health COO Becky Kuhn, whose previously-announced retirement will be effective November 3. Phoenix, Arizona-based Banner Health is an integrated delivery system that provides care in six states and officials say it is one of the largest, secular not-for-profit health systems in the nation. In 2020, Banner Health generated $10.4 billion in revenue. (Tepper, 9/15)

When the pandemic hit, the little health center on Vinalhaven, an island 15 miles off the coast of Maine, was prepared in ways many larger facilities were not. The Islands Community Medical Services had long been using telehealth to provide primary and behavioral care to its 1,500-strong year-round community, relying on grants to cover costs. As the public health emergency lifted many restrictions on virtual care, the clinic ramped up its offerings. 鈥淲e were able to pivot pretty quickly,鈥 said former operations director Christina R. Quinlan, describing a scramble to add specialized medical and social care. (Sellers, 9/15)

鈥淵ou should assume when you get a medical bill, that it might contain some type of an error. That would be a safe assumption,鈥 says Marshall Allen, author of the new book 鈥淣ever Pay the First Bill: And Other Ways to Fight the Health Care System and Win.鈥 In fact, he says, 鈥淲hen I talk to experts who review medical bills, they say that most of them contain some type of error.鈥 (Pitt, 9/15)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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