Podnosis

Interoperability has been a major focus in healthcare for the past decade. It is crucial for systems to be able to talk to one another. A patchwork of laws allow for health data sharing today through electronic health record systems and health information exchanges.

But some states believe there are situations where sharing sensitive health data may actually do more harm than good. Since the overturning of Roe v. Wade, Maryland has been thinking deeply such scenarios and to that end, passed a law to protect reproductive health data. To understand it, Anastassia Gliadkovskaya speaks to Nichole Sweeney, general counsel and chief privacy officer of the state’s designated HIE, CRISP Shared Services.  

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American Specialty Health Incorporated's ASH Care fall prevention program offers virtual assessments and exercise regimens to address falls among older adults. The program combines remote physical therapist evaluations, personalized exercise plans and coaching to improve balance and strength while reducing fall risks. Initial results show 60% to 75% of participants experienced improvements in outcome measures, with statistically significant gains in balance, strength and reduced fear of falling. ASH Care aims to enhance older adults' health and independence while potentially lowering healthcare costs associated with fall-related injuries.

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The National Committee for Quality Assurance (NCQA) has long prioritized quality in healthcare, but the COVID-19 pandemic underscored the critical role of equity as a cornerstone of quality. In recent years, NCQA has refined its HEDIS measures to be more inclusive and to better address sociodemographic factors that influence health outcomes.

In this week's episode of "Podnosis," Rachel Harrington, Ph.D., assistant vice president of health equity sciences at NCQA, shares insights into the organization’s efforts to measure and improve health equity. She discusses the importance of collecting race and ethnicity data to identify and address disparities, the challenges and progress in data collection and upcoming changes to HEDIS measures in 2025.

To learn more about the topics in this episode: 

• NCQA released its annual health plan ratings. Here's how payers fared
• How incentives engage and keep patients healthy 
• How providers are leveraging patient engagement tools to close gaps in cancer screenings

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Cyberattacks against healthcare organizations are becoming increasingly sophisticated, with new threats constantly emerging. 

In this week's episode of "Podnosis," we dive into one of the latest tactics: voice phishing, or vishing. This form of cyberattack uses AI to impersonate voices over the phone to gain unauthorized access to sensitive information.

Fierce Healthcare's Anastassia Gliadkovskaya interviews Nametag CEO Aaron Painter, who explains what vishing is, why it's a growing concern, and how organizations—especially in healthcare—can protect themselves. 

To learn more about the topics in this episode: 

• Disruptive cyberattacks against healthcare on the rise, with increasing impacts to patient care, survey finds
• 100M people impacted by massive Change Healthcare cyberattack: OCR
• Providers and payers ramp up investments in cybersecurity, AI in 2024
• Change Healthcare begins breach notifications to firms with impacted members, patients
• Cybersecurity lessons from the Change Healthcare hack

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In this week’s episode of “Podnosis,” we’re diving deep into the current landscape of clinical trials in the U.S. 

Various stakeholders face a complicated web of challenges in the system. Many patients, particularly from marginalized groups, struggle to find and get into trials. Meanwhile, with the acceleration of decentralized trial sites throughout the COVID-19 pandemic, some research programs are struggling to keep up financially. Between specialized technology, staffing and compliance measures, there’s a lot that goes into ensuring success. And unfortunately, these hardships are enough to turn some physicians away from clinical research. 

Alexander Saint-Amand is the co-founder and CEO of Topography Health, a company focused on helping medical practices and health systems conduct trials at scale. In this episode, he chats with Fierce Healthcare’s Anastassia Gliadkovskaya about what he sees as lacking in the industry today and what it will take to build out trust and capacity for the future.

To learn more about the topics in this episode:  

• HLTH24: Atropos Health unveils chat-based AI co-pilot for real-world evidence
• Dandelion Health launches AI marketplace for model validation, use in clinical trials
• Walgreens eyes 'tremendous growth' for clinical trials as part of transformation strategy

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Introducing new technology in the healthcare sector can be a challenge, especially when trying to balance innovation and practical application. 

Startups developing products for a complex ecosystem, like a hospital, may not fully understand the needs of providers on the frontlines and all the dynamics at play. A successful tool should not only address a need but also make it possible for providers to integrate into their workflow seamlessly.  

To help unpack this, Fierce Healthcare’s Anastassia Gliadkovskaya spoke to Kevin Baumlin, M.D., at the University City Science Center, where he helps founders refine their products and find the right fit within health systems. Baumlin knows firsthand that a meaningful development and implementation process includes providers from the get-go. He breaks down what this type of partnership ideally looks like and gives examples of collaboration in action.

To learn more about the topics in this episode:  

• ViVE 2024: Health systems are making big bets on AI. Here's how
• Mount Sinai launches health tech incubator, names clinical decision support startup avoMD as its first participant
• Taking a page from consumer-facing tech, Providence launches startup to modernize patient engagement

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More than one million women reach menopause each year in the U.S. Menopause can bring on many unwanted symptoms and increase the risk of chronic conditions, affecting a woman’s health and quality of life. Yet many report feeling uncomfortable talking about this challenging transition in the workplace and with their healthcare providers. Many also struggle to find relief for their symptoms. Experts say employers and providers should be doing more to care for women in midlife.  

To close out October, Menopause Awareness Month, Fierce Healthcare’s Anastassia Gliadkovskaya sat down with Kathleen Green, M.D., an OBGYN at Maven Clinic. Like many other physicians, Green did not get formal training on menopause in medical school. She had to learn how to help women through this natural part of aging. In the episode, they discuss why the status quo is not working and what it will take to improve the system.  

To learn more about the topics in this episode:  

• HLTH24 Day 2: Halle Berry wants to change the dialogue on menopause
• HLTH24: Jill Biden announces $110M ARPA-H funding award, prods industry to invest in women's health
• Menopause care is still a largely untapped market. Here's why investors and startups should dive in
• Industry Voices—Menopause is making headlines. Are healthcare workers keeping up?

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In healthcare, the best solutions come from bringing different perspectives to the table. 

That’s the core idea behind Inlightened, a platform connecting innovators with a network of vetted experts, including clinicians, industry leaders, policymakers and more. 

In this week's episode of "Podnosis," Fierce Healthcare’s Emma Beavins chats with Inlightened CEO Shelli Pavone. She explains why diverse viewpoints are essential for tackling the industry’s toughest challenges and how building real engagement is the bedrock for innovation that fills gaps in the industry and can endure.

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In the last 30 years, HIV rates have gone down, in large part because of the game-changing prescription drug pre-exposure prophylaxis (PrEP), which reduces the risk of contracting HIV through sex by 99%. Since the FDA approved the drug in 2012, more people have started to use it, and HIV rates have steadily decreased. However, not everyone sees the same results.

The South had 53% of new HIV diagnoses in 2022 but represented only 39% of PrEP users in 2023. Regionally, Black people made up 48% of new HIV diagnoses in 2022, but only 22% of PrEP users in 2023.  

In a recent collaboration between Fierce Healthcare and new investigative LGBTQ-focused news outlet Uncloseted Media, Anastassia Gliadkovskaya and Sam Donndelinger dive into the HIV epidemic and how it disproportionately affects at-risk individuals in the South. Barriers like a lack of awareness, insurance coverage, and stigma contribute to inequitable access. 

Read the full story at FierceHealthcare.com or UnclosetedMedia.com. 

In this week’s episode of “Podnosis,” Gliadkovskaya and Donndelinger discuss the reporting process and introduce three patients impacted by the HIV epidemic who share their personal experiences.

To learn more about the topics in this episode: 

• 'I'm another statistic. I feel let down': How HIV prevention stays out of reach for many

• CMS proposes risk adjustment changes, broker fraud crackdown for 2026 plan year

• ‘A mixed bag’: Fifth Circuit rules on ACA preventive services legal case

• Blue Cross NC removes HIV drugs from costly price tiers 

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There are many complexities and challenges that can lead to inefficiencies and friction among payers, providers, and healthcare consumers in the payments landscape.

In this podcast episode, we sit down with Dylan Papa and Michael Bernabe to discuss fresh perspectives for healthcare payers on how to improve claims payments operations, meet digital demands, and enhance the healthcare payments experience for all.

Zelis built Zelis Advanced Payments Platform to cleverly address these challenges by managing all payments and communications in one intelligent hub, unlocking efficiencies, ensuring compliance, and delivering the modern and customized payments experience that providers need and members demand – now, and in the future.

In this interview, Papa and Bernabe discuss the significance of combining the fusion of centralizing all payment modalities, plus communications and additional advice to payers on how to effectively modernize for the future.

To find out more, tune in to the full episode or visit Zelis.com.

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