Certificate-Of-Need Law Hampers Health Care Start-Ups
The law is supposed to prevent market saturation by requiring proof of need for the services in a community, but it also allows competitors to challenge newcomers and prevent them from entering the market. A lawsuit in Nebraska is challenging that law.
The Washington Post:
Health Care Start-Ups Are Trying To Open. An Old Law Stands In Their Way
N’da is part of a wave of litigants pressing to dismantle regulations that plaintiff lawyers say have fomented health care “cartels” in more than 30 states — limiting, for example, the number of methadone clinics in West Virginia, youth mental health beds in Arkansas and MRI centers in North Carolina. These certificate-of-need (CON) laws require certain health care and transportation businesses to demonstrate community need for their services before they can operate. The prerequisite is meant to contain costs and prevent oversaturation of the market, but it often comes with a catch: Would-be competitors can challenge applicants whose services could cut into their sales. (Najmabadi, 1/2)
The Wall Street Journal:
Sorting Opportunity From Hype In Healthcare AI
Venture capitalists increasingly must cut through hype to land the best startups in healthcare AI. Artificial intelligence’s healthcare potential is significant: faster diagnostics, novel treatments, streamlined administration and less burnout. But obstacles to success are sizable and startups face pressure to deliver on their promises. (Gormley, 1/2)
Modern Healthcare:
Claimable, SmarterDx Automate Prior Authorization Appeals With AI
As more insurance companies use automation tools in coverage decisions, some providers and patients are turning to artificial intelligence to speed up their own approval-request processes. Several vendors have added capabilities to offer providers relevant medical and insurance policy information in an instant. A flurry of startups have also launched, promising clinicians and patients more seamless methods of limiting and challenging insurance denials. (Berryman, 1/2)
Acquisitions and mergers —
Modern Healthcare:
Sanford Health, Marshfield Clinic Health System Close Merger
Sanford Health closed its merger with Marshfield Clinic Health System on Wednesday. The combined system, led by Sanford President and CEO Bill Gassen, has more than $10 billion in revenue and operates 56 hospitals across seven states, in addition to two health plans with roughly 425,000 members. It has almost 56,000 employees, including about 13,000 employees from Marshfield, according to a Thursday news release. (Hudson, 1/2)
Modern Healthcare:
CareSource Acquires ACA C-Op Common Ground Healthcare
CareSource has completed its acquisition of Common Ground Healthcare Cooperative, the nonprofit health insurers announced in a news release Thursday. Privately held CareSource, which has 2 million Medicare, Medicaid and health insurance exchange members, gains 54,000 marketplace customers in Wisconsin through the deal. Common Ground CEO Cathy Mahaffey remains as chief executive of Common Ground Healthcare Cooperative and was named CareSource market president for the Badger State. (Tepper, 1/2)
Modern Healthcare:
Pennant Group Closes Signature Healthcare At Home Deal
Home health and hospice provider Pennant Group completed the second phase of its $80 million acquisition of Signature Healthcare at Home assets in the Pacific Northwest. The deal, which was completed Jan. 1, includes seven home health and hospice locations across Oregon, Pennant Group said in a Thursday news release. The Eagle, Idaho-based company completed the purchase of six other Signature Healthcare locations in Washington and Idaho in August. (Eastabrook, 1/2)
Modern Healthcare:
Ensign Group Acquires 9 Nursing Homes In Tennessee, Alabama
The Ensign Group has completed the acquisition of nine skilled nursing home operations in Tennessee and Alabama. The San Juan Capistrano, California-based company said in a press release Thursday eight of the facilities are located in Tennessee. (Eastabrook, 1/2)
