While many states have embraced the shift to modular Medicaid Enterprise Systems, the journey to modularity does not come without risks. In this Fierce Healthcare podcast, Rajesh Sharma, vice president and general manager of Gainwell Technologies’ systems integration, data analytics and interoperability product offering, provides practical and proven strategies to help states navigate the various opportunities and challenges that modernization presents.

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The U.S. is in a pregnancy care crisis. The country has the highest maternal mortality rate among comparable wealthy countries, according to Centers for Disease Control and Prevention data. Senior editor Heather Landi spoke with Alison Cowan, M.D., head of medical affairs at personalized pregnancy startup Mirvie and a practicing OB-GYN, about how to improve and modernize the U.S. healthcare system for pregnant women.

Also, senior editor Paige Minemyer talks to Chinni Pulluru, M.D., vice president of clinical operations at Walmart Health and Wellness, about lessons since the retail giant launched its first health clinics in 2019. With retail’s push into healthcare, these companies promise a more convenient experience, but traditional providers have expressed some concerns as Walmart and others edge onto their turf. 

To learn more about topics in this episode:

• Mirvie mRNA study predicts premature births 2 months in advance
• US women face worse outcomes, higher costs than in other wealthy countries
• Maternal deaths continued to rise nationwide in 2020, especially among Black and older mothers
• Walmart Health plans to open 16 more Florida clinics next year
• CVS plans to make a major primary care play by the end of 2022
• Walgreens, Alphabet's Wing kick off drone delivery service in major metro area

Podnosis is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Heather Landi and Paige Minemyer. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.

See omnystudio.com/listener for privacy information.

There are sides of pregnancy not seen on social networks or "new mom" newsletters. In this podcast, we hear the side of "expecting" that's not often spoken about in public. This is part 1 of a 4-part series. To hear more, search for "The Invisible Weight" wherever you listen to podcasts.

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Nonprofit hospitals in the U.S. are required to provide community benefits as a condition of their tax exemption status. But research suggests those dollars represent only about 2% or 3% of the total expenses that hospitals report. Some say this isn’t enough to warrant the tax breaks they enjoy.  Fierce Healthcare's Dave Muoio talks with Dr. Christopher Goodman from Prisma Health. He and his co-authors reviewed hospitals’ charity care policies from 2019 to 2021 to track changes in charity care policy.   

COVID-19’s impacts are still rocking the industry. Healthcare workers and leaders face some of the largest challenges that have ever been put before them, and this is especially true for women. The Fierce Healthcare team is recognizing 10 women making a big impact on healthcare. We'll discuss this year's honorees. 

To learn more about topics in this episode: 

• Nonprofit hospitals expanded charity care policies after COVID. But some changes raise red flags, study finds
• California attorney general scolds hospitals for withholding charity care policy info from patients
• AHA: Nonprofit hospitals provided community benefits 9 times higher than 2019 tax exemptions
• Fierce Healthcare's 2022 Women of Influence Awards

Podnosis is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Heather Landi and Paige Minemyer. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.

See omnystudio.com/listener for privacy information.

The American Data Privacy and Protection Act says it would protect “any information that describes or reveals the past, present or future physical health, mental health, disability, diagnosis or healthcare treatment of an individual.” The bill, introduced in July, comes at a time when more tech companies are breaking into the healthcare space and eyes are turning to the protection of reproductive health data. To gain insight into the bill’s uncertain future, Fierce’s Annie Burky spoke with Deven McGraw, lead of data stewardship and sharing at medical genetic company Invitae.

And listen in on a snippet from a panel senior editor Heather Landi moderated at Digital Pharma East on leveraging digital health tools and social determinants data to improve patients’ health.

To learn more about topics in this episode: 

• Post-Dobbs data privacy law in flux as experts, providers and tech companies rethink how to protect patient information
• Post Dobbs fallout tracker—Nationwide legal abortions declined 6% from April to August, report estimates
• Most physicians unclear on 'life-threatening emergencies' under abortion bans: survey
• Backlash against CVS, Walgreens raises questions about role of retail in post-Dobbs world
• Deloitte: Health inequities cost industry $320B per year, signal unsustainable crisis
• RISE 2022: Health plans grapple with how to acquire, implement health equity data
• DarioHealth lands $30M deal with Sanofi to expand commercial reach of its digital therapeutics
• Digital Pharma East

Podnosis is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Heather Landi and Paige Minemyer. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.

See omnystudio.com/listener for privacy information.

Medicare’s annual enrollment window is underway. That means a flurry of activity for health insurers, which are aiming to grow their reach in the very hot Medicare Advantage market. Paige Minemyer talks with executives at the Fierce Health Payer summit to discuss how payers are shifting their sales and outreach approach. 

Paige also hosted a panel to discuss what the post-pandemic landscape looks like for social determinants of health and the latest innovations MA players can bring to the table to address those social needs.  

To learn more about topics in this episode: 

• Fierce Health Payer Forum
• Medicare Advantage at the tipping point: A preview of 2023 open enrollment
• ACHP: Nonprofit Medicare Advantage plans made up one-third of 5-star options
• House progressive bill wants to take Medicare out of Medicare Advantage's name
• Humana joins forces with USAA for new co-branded MA plan for veterans
• Medicare Advantage star ratings show steep declines for 2023 as pandemic flexibilities go away

Podnosis is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Heather Landi and Paige Minemyer. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.

See omnystudio.com/listener for privacy information.

Home tests are becoming more popular, so companies have to think outside the box to stay competitive. We talked with Liz Kwo, the chief medical officer at Everly Heath, a company that offers a virtual diagnostics-driven care platform, about where home testing started out, and where it’s headed. Also under discussion is open enrollment for next year’s Medicare Advantage program, and the key issues and trends we're seeing.

To learn more about topics in this episode: 

• Healthcare startups roll out at-home COVID-19 test kits amid testing lag
• Medicare to cover at-home COVID-19 tests this spring after backlash from lawmakers
• Everly Health taps Anthem exec to lead clinical strategy as startup builds out home health testing
• Blood test may help identify patients at risk for long COVID: study
• Medicare open enrollment is on the horizon. Here's what 5 major payers have planned
• Medicare Advantage at the tipping point: A preview of 2023 open enrollment
• Medicare Advantage star ratings show steep declines for 2023 as pandemic flexibilities go away

Podnosis is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Heather Landi and Paige Minemyer. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.

See omnystudio.com/listener for privacy information.

At Fierce Healthcare, we aim to spotlight some of the important contributions made by people of color across health systems, physicians' offices, health tech and insurance companies.  For the past three years, Fierce Healthcare has selected 10 leaders to honor for the measurable impact they have made on the healthcare industry. 

Also under discussion is what retail corporations are doing in healthcare. Healthcare is a $4 trillion industry. And companies with deep pockets are trying to get a slice of the pie by providing medical services. We'll make sense of how the sector has evolved in the last two years with our guest Natalie Schibell, vice president and research director at Forrester, a global market research company.

To learn more about topics in this episode: 

• Fierce Healthcare's most influential minority executives in healthcare for 2022
• Amazon Care shutdown is a strategic play, not a failure, some healthcare experts say 
• 2022 forecast: Competition in retail healthcare will heat up. Here's what to expect from Amazon, CVS and Walgreens
• Healthcare industry will face higher medication errors, declining patient trust in 2022: Forrester
• Healthcare plays by CVS, Walgreens and Amazon will drive more partnerships, tech investment, experts say
• Fierce Health Payer Forum

Podnosis is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Heather Landi and Paige Minemyer. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.

See omnystudio.com/listener for privacy information.

Hospitals and healthcare organizations are becoming targets for cyber-attacks with potentially deadly consequences. In 2020, there was a ransomware attack on The University of Vermont Health Network. It’s estimated that the attack cost the health system $63 million dollars. In partnership with the Ponemon Institute, Cynerio released a study in early August titled “The Insecurity of Connected Devices in Healthcare 2022.” The study surveyed healthcare leaders from 517 hospitals in North America and found that 56% of them said they’ve been attacked in the past 2 years. And 47% of those attacked paid the ransom. The study also showed how these frequent cyber-attacks are impacting patient care. On today's episode, Fierce's Annie Burkey talks with Chad Holmes, a security consultant and current security evangelist at Cynerio, about what this means for safety and privacy.  

Also under discussion is social determinants of health. Believe it or not they drive up to 70% of health outcomes. They impact access to nutritious food or safe housing. Social determinants have always existed, but it wasn’t until recently that the federal government officially decided to measure them. Last year, The Physicians Foundation published a comprehensive framework for addressing social determinants. They proposed quality measures to the Centers for Medicare and Medicaid Services, which were approved in August, becoming the first time social drivers are recognized in federal payment programs. As of 2023, participating hospitals will be required to report what portion of their population is screened for social drivers and how many screen positive for each kind. Fierce's Anastassia Gliadkovskaya speaks with Gary Price, president of the Physicians Foundation.

To learn more about topics in this episode: 

• CMS approves first measures to track social determinants at federal level 
• Most doctors have patients affected by social drivers but feel ill-equipped to address them, survey finds 
• Industry widely sees equity as important, but lacks concrete steps to address it, survey finds 
• New legislation calls on CMMI to create model based on health equity 
• Medical devices are a weak link in hospital cyber defenses, putting patients in the crossfire: study
• Ransomware attacks impact patient care, including increased mortality rates, report finds
• Healthcare data breach costs reach record high at $10M per attack: IBM report 
• Amid warnings of potential Russian cyberattacks, new Senate bill directs CISA, HHS to shore up digital defenses

Podnosis is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Heather Landi and Paige Minemyer. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.

See omnystudio.com/listener for privacy information.

While there has been a lot of hype about AI radically transforming healthcare, adoption has been slower and more measured than previously predicted. Instead of replacing doctors, clinicians are using AI as a tool to improve everything from their diagnoses to billing practices. Last year, healthcare AI startups raised $12.4 billion. That’s nearly double the previous year. But there are some concerns like with privacy around using patients' data. Fierce’s Senior Editor Heather Landi talks with Dr. John Halamka, who leads Mayo Clinic’s digital health and AI projects to find out about what is standing in the way of more widespread use and what organizations should be doing to protect patients’ data. 

Also on the podcast, we'll discuss social factors that in fact play a significant role in a person’s overall health, like poverty, racism, unequal access to healthcare or lack of education. Healthcare industry insiders are aware of this challenge. So, with that backdrop, payers have invested significantly in bringing on the expertise necessary to tackle these social needs both at scale and across a variety of communities. At UnitedHealthcare, that work is led by Dr. Alex Billioux. He chats with Fierce Healthcare's senior editor Paige Minemeyer to discuss how payers can address social needs to really make a difference in these challenges. 

To learn more about topics in this episode: 

• Executive Spotlight—John Halamka on his move to Mayo Clinic and what excites him about the future of health IT
• One year of COVID: John Halamka reflects on how the pandemic spurred collaboration—and a lot of goat grooming
• Mayo Clinic's Halamka: Telehealth boom slowing, but don't expect it to go back to pre-COVID rates
• Meet the executive leading UnitedHealthcare's social determinants strategy
• Why UnitedHealthcare wants to expand diagnostic codes to the social determinants of health 
• CMS approves first measures to track social determinants at federal level
• Fierce Health Payer Forum

Podnosis is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Heather Landi and Paige Minemyer. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.

See omnystudio.com/listener for privacy information.