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Morning Briefing

Summaries of health policy coverage from major news organizations

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Monday, Oct 5 2020

Full Issue

'Burdensome': High Number Of Probes Into Health Care Fraud Cost Providers

Modern Healthcare looks at what's behind a spike in investigations launched by prosecutors that sometimes seem to be fishing expeditions.

The possibility of scoring a lucrative healthcare fraud settlement may be spurring broad information requests by the government that look more like 鈥渇ishing expeditions鈥 than targeted investigations, and as a result are driving up providers鈥 costs, legal experts said. Healthcare fraud investigations have consistently netted the government more than $2 billion in settlements a year since 2010, with whistleblowers recouping hundreds of millions of that share annually, according to U.S. Justice Department data. A 鈥渉istoric鈥 $6 billion healthcare fraud investigation unveiled last week will likely fuel more federal and state probes. (Kacik, 10/3)

Advocate Aurora Health and Beaumont Health have put an end to their discussions around a potential partnership, officials announced Friday.聽The announcement comes months after the two organizations signed a letter of intent to open discussions. (Reed, 10/2)

Blue Cross and Blue Shield of N.C. and Wake Forest Baptist Medical Center have formed their second health insurance network to serve the Triad. Blue Cross said it will offer, starting in January, what it is marketing as Blue High Performance network. The network provides members with access to a comprehensive set of doctors, hospitals and specialists, while lowering costs for employers. (Craver, 10/4)

COVID-19's financial impact on New Jersey hospitals has reached "historic levels," with nearly 60% of providers reporting negative net margins throughout the first half of the year as a result of the pandemic. A mid-year snapshot of financial data released Friday by the New Jersey Hospital Association found providers statewide experienced significant declines in both patient volume and revenue compared to the same time last year. (Johnson, 10/2)

The number of hospitalized coronavirus patients is steadily increasing across Massachusetts as health care leaders dig in for what they suspect will be a long winter of illness and unease. Since late August, when the number of hospitalized coronavirus patients across Massachusetts hit a low, the caseloads are up 41 percent, according to Sunday鈥檚 data from the state鈥檚 Department of Public Health. The steepest increases have come in the past two weeks. (Lazar, 10/4)

If not for an anthropologist and sociologist, the leaders of a prominent health innovation hub at Duke University would never have known that the clinical AI tool they had been using on hospital patients for two years was making life far more difficult for its nurses. The tool, which uses deep learning to determine the chances a hospital patient will develop sepsis, has had an overwhelmingly positive impact on patients. But the tool required that nurses present its results 鈥 in the form of a color-coded risk scorecard 鈥 to clinicians, including physicians they鈥檇 never worked with before. It disrupted the hospital鈥檚 traditional power hierarchy and workflow, rendering nurses uncomfortable and doctors defensive. (Brodwin, 10/5)

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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