New Price Transparency Rules Unveiled by Trump Administration

This morning, the Trump Administration issued two rules to increase healthcare price transparency, at both hospital and payer levels.

Today, as directed by an Executive Order from President Trump, the Department of Health and Human Services announced that the Centers for Medicare and Medicaid Services (CMS) has issued two rules to increase healthcare price transparency, at both hospital and payer levels.

The rule changes require that pricing information be made publicly available in an effort to “increase price transparency to empower patients and increase competition among all hospitals, group health plans and health insurance issuers in the individual and group markets,” as it was stated by HHS in a press release this morning.

The first—”Calendar Year (CY) 2020 Outpatient Prospective Payment System (OPPS) & Ambulatory Surgical Center (ASC) Price Transparency Requirements for Hospitals to Make Standard Charges Public Final Rule”—is a rule that requires hospitals to make all standard charges, including gross charges, payer-specific negotiated rates, the amount a hospital is willing to accept in cash from a patient, and the minimum and maximum negotiated charges, public on the internet in a machine-readable file.

The second rule change, known as the “Transparency in Coverage” rule, which was proposed jointly by the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury, would require most health insurers, including those issuing employer-based group health plans, to disclose price and cost-sharing information to participants, beneficiaries, and enrollees up front.

“President Trump has promised American patients ‘A+’ healthcare transparency, but right now our system probably deserves an F on transparency. President Trump is going to change that, with what will be revolutionary changes for our healthcare system,” said HHS Secretary Alex Azar in this morning’s press release. “Today’s transparency announcement may be a more significant change to American healthcare markets than any other single thing we’ve done, by shining light on the costs of our shadowy system and finally putting the American patient in control.”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Drones are Coming

Access to healthcare saw great progress this past week, with the first residential deliveries of prescriptions via autonomous drone.

It sounds like the future, but it’s happening now: prescriptions delivered via drone.

On November 1st, CVS Pharmacy and UPS’s Flight Forward subsidiary successfully used drones to deliver prescriptions to the homes of customers for the very first time.

The drone, which was developed by Matternet, departed on its inaugural flight from a CVS store in Cary, North Carolina and flew to two customers’ homes, where it then hovered about 20 feet over the ground and slowly lowered the packages to the ground via a cable and winch. One of the packages was delivered to a CVS customer with limited mobility, which makes it difficult for them to travel to a store to pick up a prescription—exactly the sort to customer CVS and UPS had in mind while getting into the drone delivery business.

“This drone delivery, the first of its kind in the industry, demonstrates what’s possible for our customers who can’t easily make it into our stores,” said Kevin Hourican, president of CVS Pharmacy, in a press release. “CVS is exploring many types of delivery options for urban, suburban and rural markets. We see big potential in drone delivery in rural communities where life-saving medications are needed and consumers at times cannot conveniently access one of our stores.”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Hospitals Sue Drug Makers Over Cost of Treating Opioid Addiction

In recent weeks, hundreds of hospitals have joined the fight against the opioid epidemic by filing suits against the highly addictive drug’s makers and distributors.

In recent weeks, hundreds of hospitals have joined cities and counties across the country in the fight against the opioid epidemic by filing suits against the highly addictive drug’s makers and distributors, in an effort to recoup the cost of treating uninsured opioid users for addiction. This comes on the heels of thousands of suits filed in state and federal court, aiming to hold Perdue Pharma, Johnson & Johnson, McKesson Corp. and others in the pharmaceutical industry responsible for the more than 400,000 opioid-related deaths that have occurred since 1999.

According to court documents, hospitals estimate treating opioid-related addiction costs an average of $107,000 per person, and the total costs to U.S. hospitals in just one year exceeded $15 billion.

“The expense of treating overdose and opioid-addicted patients has skyrocketed, straining the resources of hospitals throughout our state,” Lee Bond, Chief Executive Officer of Singing River Health System in Mississippi, said in a statement.

So far, suits have been filed in Arizona, Florida, Kentucky, Mississippi, Tennessee, Texas, and West Virginia, with more likely to follow in other states around the country.

The lead defendant in the suits, Purdue Pharma, has thus far not responded to requests for comment.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Healthcare Wastes up to $935 Billion Annually

Waste in the U.S. healthcare system accounts for nearly 25% of total spending, or $760 to $935 billion annually, according to a report published this week.

Waste in the U.S. healthcare system accounts for nearly 25% of total spending, or $760 to $935 billion annually, according to a report published this week in JAMA Open Network.

For the report, researchers broke the U.S. healthcare system’s waste into six categories, including failure of care delivery, failure of care coordination, over treatment or low-value care, pricing failure, fraud and waste, and administrative complexity. Administrative complexity accounted for the most waste, equaling $265.6 billion annually. The second most costly category was pricing failure, totaling up to $240.5 billion.

“The estimated total costs of waste and potential savings from interventions that address waste are as high as $760 billion to $935 billion and $191 billion to $282 billion, respectively,” Dr. William Shrank, Chief Medical Officer at Humana, and his colleagues wrote in the report, which was published on Monday. “These estimates represent approximately 25% of total health care expenditures in the United States, which have been projected to be $3.82 trillion for 2019.”

The report also noted that the United States currently spends more on healthcare than any other country, with costs nearing $3.6 trillion, or 18% of the gross domestic product.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Write Your Best Healthcare Résumé Yet

Even if you’re not actively seeking, it’s always a good idea to have an impressive résumé at the ready, just in case an ideal job happens to pop up on your radar.

Hiring in healthcare is pretty much always booming, but it can be particularly active at the end and beginning of any given year. So, as October begins, it may be time to reevaluate your résumé. Even if you are not actively seeking a position, it is always a good idea to have an impressive résumé at the ready, just in case an ideal job happens to pop up on your radar. Follow the tips below to make sure your résumé is the best it can be.

Ditch the Old Format

Times change and things evolve, and résumés are no exception. The age-old format of an objective, a chronological list of experience, education, and then “references available upon request” slapped at the bottom is no longer going to impress anyone. It’s like whipping out a flip phone from the year 2000 in the middle of the Apple store on the release day of the new iPhone. Get with the times and restructure your résumé to the more current format of:

  • Name & Contact Info: Your full name, address, phone number, professional email address, and optional social links, right at that top and easy to locate.
  • Summary: A dynamic keyword-infused paragraph, that illustrates your experience, accomplishments, most desirable characteristics, and career goals.
  • Skills & Qualifications: A bulleted or otherwise easy-to-follow section containing your most valuable and important job-related abilities, including specialties, settings, and even the languages you speak.
  • Experience: Listed in clearly defined sections by position, in chronological order, with the most recent at the top, including impressive or noteworthy achievements and specialized skills, not just your day-to-day duties.
  • Education: Your scholastic accomplishments, including degrees, licensures, and/or certifications, and the dates they are valid through, if applicable, as well as when and where you obtained them from. If you are early on in your career, it is perfectly acceptable to swap the order of the Education and Experience sections.

Tailor Your Résumé for Each Application

It may take a bit more time and effort, but altering your résumé to match the description of the job you are applying for can make all the difference when it comes to standing out from the competition. Make sure the keywords in your résumé match the duties and requirements used in the job posting to demonstrate what a seamless match you would be. The more your résumé aligns with what the employer is looking for, the better your odds of making it to the next step in the hiring process.

Include a Cover Letter

A cover letter is the peanut butter to a résumé’s jelly. 22% of Hiring Managers consider it a red flag, if an applicant does not include a cover letter, and while that means 88% are unbothered by it, you have no way of knowing which type of Hiring Manager your résumé is being submitted to. Including a thoughtful cover letter, which is equally tailored to the job and hiring company as your résumé, is a best practice to follow. The body of your cover letter should be used to detail why you would be the right fit for the position and the company you are applying to, and done so in a way that the Hiring Manager will want to move on to your résumé and learn more about you and your qualifications.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Officials Caution 2019-2020 Flu Season May Be Severe

After the flu claimed the life of a 4-year-old in California, health officials are warning that the upcoming flu season could be severe.

Health officials are warning that the upcoming 2019-2020 flu season could be severe, as reported by U.S. News & World Report.

The warning comes on the heels of the first reported flu-related death, which claimed the life of a 4-year-old in California earlier this month.

“A death so early in the flu season suggests this year may be worse than usual,” cautioned Dr. Cameron Kaiser, a health official from Riverside County, where the child was from, in a press release.

The Centers for Disease Control and Prevention recently reported that the previous flu season, which ran from October 2018 to May of 2019, was of “moderate severity.” It should also be noted that the 2018-2019 flu season, which lasted 21 weeks, was the longest flu season in a decade, and that, according to the CDC, there were around 600,000 flu-related hospitalizations and between 36,400 and 61,200 flu-related deaths reported.

For the 2019-2020 flu season, officials have recommended flu shots be administered before the end of October, and caution against vaccinating too early, such as in July or August, as reduced protection against the flu may occur. The CDC states that “all persons aged 6 months and older are recommended for annual vaccination, with rare exception.”

Flu vaccines are updated to better combat the strains that are expected to be circulating in the United States. This year:

  • The A(H1N1)pdm09 vaccine component was updated from an A/Michigan/45/2015 (H1N1)pdm09-like virus to an A/Brisbane/02/2018 (H1N1)pdm09-like virus.
  • The A(H3N2) vaccine component was updated from an A/Singapore/INFIMH-16-0019/2016 A(H3N2)-like virus to an A/Kansas/14/2017 (H3N2)-like virus.
  • Both B/Victoria and B/Yamagata virus components from the 2018-2019 flu vaccine remain the same for the 2019-2020 flu vaccine.
  • All regular-dose flu shots will be quadrivalent.

For more in-depth information about the 2019-2020 flu season, the CDC offers a FAQ resource center, which can be accessed at https://www.cdc.gov/flu/season/faq-flu-season-2019-2020.htm.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Number of Uninsured Americans up for the First Time in 10 Years

For the first time in a decade, the number of Americans without health insurance has risen, up by about 2 million people in 2018.

Phil Galewitz, Kaiser Health News

For the first time in a decade, the number of Americans without health insurance has risen — by about 2 million people in 2018 — according to the annual U.S. Census Bureau report released Tuesday.

The Census found that 8.5% of the U.S. population went without medical insurance for all of 2018, up from 7.9% in 2017. By contrast, in 2013, before the Affordable Care Act took full effect, 13.3% were uninsured. It was the first year-to-year increase since 2008-09, Census officials said.

Census officials said most of drop in health coverage was related to a 0.7% decline in Medicaid participants. The number of people with private insurance remained steady and there was a 0.4% increase in those on Medicare.

Many of those losing coverage were non-citizens, a possible fallout from the Trump administration’s tough immigration policies and rhetoric. About 574,000 non-citizens lost coverage in 2018, a drop of about 2.3%, the report found.

“Uninsured non-citizens account for almost a third of the increase in uninsured, which may reflect the administration’s more aggressive stance on immigration,” said Joseph Antos, a health economist at the American Enterprise Institute.

The increase in the number of uninsured people in 2018 was remarkable because uninsured rates typically fall or hold steady when unemployment rates drop. The U.S. unemployment rate fell slightly from about 4.3% in 2017 to 4% in 2018.

The uninsured rate continued to vary by poverty status and whether a state expanded its Medicaid program under Obamacare. Texas (17.7%), Oklahoma (14.2%), Georgia (13.7%) and Florida (13%) had the highest uninsured rates in 2018, according to the report. None of those states have expanded Medicaid under Obamacare.

The percentage of uninsured children under the age of 19 increased by 0.6 percentage points from 2017 to 2018, to 5.5%.

“The Census data are clear — the uninsured rate for kids is up sharply and it’s due to a loss of public coverage — mostly Medicaid,” Joan Alker, executive director of Georgetown University Center for Children and Families, said in a statement.

“These children are not getting private coverage as the Trump Administration has suggested but rather becoming uninsured,” she said. “This serious erosion of children’s health coverage is due in large part to the Trump Administration’s actions that have made health care harder to access and have deterred families from enrolling their children.”

The share of Americans without medical insurance fell steadily since 2014 but then leveled off in 2017, the year Donald Trump became president.

Health care advocates have complained that efforts by the Trump administration and Congress are jeopardizing insurance enrollment. They point to cuts in outreach programs that aim to tell consumers about their health care options under Obamacare and the elimination of the ACA’s tax penalty for people who don’t have health coverage.

Alker complained that the administration’s policies are causing the loss of children’s coverage. “In a period of continued economic and job growth, we shouldn’t be going backwards on health coverage,” said Judy Solomon, a senior fellow for the Center on Budget and Policy Priorities, a left-leaning think tank. “This backsliding almost certainly reflects, at least in part, Trump administration policies to weaken public health coverage.”

She attributed the drop to the Trump administration making it harder for families to enroll for coverage in Medicaid by curtailing outreach efforts, allowing states to ask for more paperwork and proposing a so-called public charge rule that would make it harder for legal immigrants to get permanent resident status if they have received certain kinds of public assistance — including Medicaid.

Tom Miller, a resident fellow at the American Enterprise Institute, a conservative think tank, said the drop in Medicaid coverage “is a positive.”

“When the economy grows Medicaid eventually drops,” he said.

One reason for the drop in health coverage is that middle-income families can’t afford the rising cost of insurance in the individual market, particularly if they don’t qualify for government subsidies, he added.

“On balance, this is some short-term noise,” he said of the uptick in the uninsured rate. “I would put more stake in it if happens for several years.”

Chris Pope, a senior fellow with the conservative Manhattan Institute, also said he considered the change “fairly small” and likely due to increasing wages “pushing people above the income eligibility cutoff in Medicaid expansion states.”

But he suggested that next year would be a better indicator of how changes in the ACA are playing out.

“I expect that the mandate repeal will make next year’s increase in the uninsured more significant,” he said.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

AI’s Future in Healthcare Is Not Entirely Rosy

There is a lot of interest and excitement surrounding integrating AI into healthcare, but there are a lot of hurdles that still need to be addressed.

By Alex Tate

There is a lot of interest and excitement surrounding Artificial Intelligence, or AI, and how it can bring sweeping changes to the healthcare ecosystem. The potential of AI is unlimited, and its avenues in healthcare are still predominantly unexplored. According to Accenture, successful and effective implementation of AI can save the US government up to $150 billion per annum, by 2026. For a government that is generously spending $3.5 trillion each year on its healthcare needs, such sizeable savings can ease some pressure. Accenture also predicts that the AI healthcare market will be valued at $6.6 billion by 2021.

However, despite all of the encouraging statistics, AI still has a cloud of uncertainty associated with it. There are various reasons why people are not comfortable with incorporating AI into healthcare. Technological limitations and complicated intricacies related to AI also do not help its cause. Even though experts are optimistic that AI will rejuvenate the healthcare system, there are implications which cast doubts over its future.

Here are some reasons why the use of AI in healthcare proves challenging:

AI Is Still a Black Box

In IT, black box refers to something which is not entirely understood, in terms of its internal workings. For example, you may know how to turn on your laptop by pressing the power button, but you are unsure what internal mechanisms kick-in during the process of turning on your device. In that case, a laptop may be a black box for you.

For data scientists and IT experts, AI is very much a black box. They are able to derive limited work from AI, but are, themselves, unsure how AI actually works. In theory, AI works by machine learning and neural networks. However, the exact intricacies and algorithms are still less understood.

Inadequate Technology to Support AI

Our current technology, especially in terms of hardware, is not fully capable of running AI and its algorithms. Only the most advanced supercomputers can manage AI. Whereas, the servers that most hospitals currently have may not be fully equipped to deal with the set of processes that take place in AI.

Public Acceptance

Even if we are able to comprehend AI completely, we may not be able to incorporate it into the healthcare setup, unless the public feels comfortable with it. People can be quite distrustful when it comes to the manipulation of their data. As long as AI does not get social acceptance, giving AI access to PHI (Protected Health Information) would be unethical.

Data Protection and Privacy Issues

The American healthcare system takes healthcare privacy very seriously. Breaches in patient information are punishable by a maximum fine of $1.5 million per violation. In light of such strict rules and hefty punishments in cases of non-compliance, scientists cannot risk giving AI open access to patient data. Even if we are able to understand the mechanism of AI, ensuring that data breaches do not happen would be an even more significant challenge. The downside of AI is, if this technology gets into the wrong hands, all the current protocols of data safety will become null and void.

Compliance and Regulations

Since the enactment of HIPAA, the US Government has been regularly enforcing compliances on the healthcare sector to ensure the safety of clinical information. Once AI regularly features in healthcare, the government may be required to enact a new set of regulations to streamline the applications of AI. At this stage, the scientists themselves are not sure how AI works. Aligning AI to federal and state compliances would be a different ordeal.

Employee Layoffs

Reduction in job security due to increased automation and ‘smarter’ computers has been a growing dilemma over the last few years. Since machines are taking over much of the work previously performed manually and businesses are pushing to reduce costs in the ever-competitive healthcare arena, showing employees the door is becoming increasingly common. A decrease in healthcare jobs, as a result of AI, will not only increase unemployment but it will also have detrimental effects on the national economy.

Limited Decision Making for Providers

Richard Baldwin said, “No matter how advanced AI gets, it may never have the ability to be creative and think independently – something which natural intelligence is optimized to do.”

With AI having complete access to patient data, it might be able to prescribe treatments on its own. This process may hinder the provider’s own ability to judge and do the requisite decision making. It can also make a provider complacent, which can be dangerous if the AI commits an error. As long as AI does not become error-free, we cannot trust it to make decisions that a seasoned provider can.

Curtailed Provider-Patient Relationships

AI will completely change the dynamics of the provider-patient relationship. Since AI would be doing most of the things, the provider may not have holistic control over the entire treatment process. AI will also allow patients to self-diagnose their ailments, and the providers would be required to justify it, instead of examining the patient and diagnosing appropriately.

Accountability Issues

In case AI fails to function appropriately and presents erroneous information, no one can be held accountable for it. In case of a wrong prescription due to AI, there is no way for a patient to be compensated. Also, there are no enacted laws and regulations covering errors due to AI. Considering that, at this point, we do not have a complete understanding of AI, resolving such errors would be another challenge.

Hefty Training Costs

During the implementation process of AI, providers and support staff would need specialized training on AI. Making AI comprehendible for providers who are usually not fluent in IT dialects, would be very difficult and may take several weeks of training, if not months. Plus, the support system delegated for AI-backed healthcare software would also need extensive training.

AI is probably the most advanced technological innovation that humanity has ever witnessed. In its pilot testing, AI has shown signs of promise, but its future is full of bumpy rides and twisty roads. Like most other technological innovations, one day, we may master AI and all its complexities, but for now, that phase seems distant. Until we reach that phase, we should not rely on AI and trust natural intelligence to do the crucial decision-making in the healthcare sector.


Alex Tate has served in various positions at health IT organizations for the past thirteen years. Most recently as Vice President at a leading EHR organization. He is currently overseeing EHR Programs and revenue cycle consulting for a number of organizations. He has previously supervised the development of many emerging products and held leadership roles in health-tech strategy, operations, service organization development, delivery, and optimization.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Landmark Decision Holds Drug Maker Responsible In Opioid Crisis

An estimated 130+ people die every day from opioid-related drug overdoses, and now a landmark decision in Oklahoma is holding one drug maker responsible.

An Oklahoma judge has ruled that pharmaceutical company Johnson & Johnson deceptively marketed opioids, which helped fuel the state’s opioid crisis, a crisis that claimed the lives of more than 6,000 people, and must pay $572 million to the state.

The landmark decision, which was handed down by Judge Thad Balkman on Monday, is the first of its kind, in which a pharmaceutical company is being held directly responsible for one of the worst drug epidemics in American history.

“Defendants caused an opioid crisis that is evidenced by increased rates of addiction, overdose deaths and neonatal abstinence syndrome in Oklahoma,” Judge Balkman said in the ruling.

Johnson & Johnson immediately released a statement in which it was said that the company “plans to appeal the opioid judgment in Oklahoma.”

The case and the subsequent ruling have undoubtedly been closely watched by plaintiffs in other opioid lawsuits, of which there are currently more than 2,000 pending.

It is estimated that more than 130 people die every day in the United States from opioid-related drug overdoses.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

4 Technologies to Know About for Your Clinic

Keeping up with the latest technology is vital for the success of your clinic. Here are four to know about to help you innovate.

By Lizzie Weakley

Keeping up with the latest technology is vital for the success of your clinic. As the healthcare landscape becomes more competitive, having advanced equipment can attract new patients and retain current ones. Technological innovations can also make your clinic more efficient by reducing diagnosis and treatment time. Here are four technologies to consider adding to your practice today.

Advanced Ultrasound Machines

Ultrasound is a safe, effective and non-invasive way to view internal parts of the body. However, the most well-known use of ultrasound is during prenatal exams to check the health of the fetus and give the parents a first look at their new baby. Adding advanced ultrasound technology, such as 3D and 4D ultrasounds, to your practice can not only improve diagnostic capabilities but also bring in revenue from expecting parents who are willing to pay extra for more detailed images.

Thermal Imaging

The use of a thermal camera to diagnose and monitor certain medical condition is one of the biggest recent advancements in healthcare. Unlike many other imaging technologies, thermal imaging is completely safe and painless with no radiation exposure. This technology is often used to help detect breast cancer by measuring the heat signatures produced by the blood vessels surrounding a tumor.

MelaFind Scanner

Skin cancer is the most common form of cancer. While the aggressive type called melanoma only accounts for one percent of these cancers, it is responsible for the majority of skin cancer deaths. A non-invasive optical scanning technology known as MelaFind may revolutionize the early detection of this deadly cancer and reduce the need for painful biopsies. MelaFind is an easy-to-use handheld device that can analyze moles and lesions deep below the skin.

Telemedicine

Many people find it difficult to fit doctor appointments into their busy schedules. Telemedicine is a great way to reach these patients and help them manage their health more effectively. Conducting appointments via video conference allows patients to be seen and treated from their home, office or on the go. Another use of telemedicine is robotic technology in hospitals. Robot nurses equipped with video can check in on patients and free up staff for more important tasks.

Remember, just having advanced technology in your clinic isn’t enough. You must also invest in experienced, well-trained staff who can put that technology to use. Many advanced pieces of medical equipment require special training in order to use them effectively. Don’t forget to budget for training and new hires when considering a technology upgrade.


Lizzie Weakley is a freelance writer from Columbus, Ohio. In her free time, she enjoys the outdoors and walks in the park with her husky, Snowball.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.