Health Care Providers Indirectly Hit By Medicare Advantage Star Rating Slips

Modern Healthcare: Medicare Advantage Star Ratings Declines Cause Problems For Providers 
Declining Medicare Advantage star ratings have led health insurance companies to seek cost savings that are having downstream consequences for healthcare providers. The quality measurement program applies only to insurers, but their responses to toughened standards and less bonus revenue has implications for providers engaged in risk-sharing arrangements with them, executives said. (Tepper and Devereaux, 11/20)

Modern Healthcare: Will The Nursing Home Ownership Rule Force Private Equity’s Exit?
The regulation announced last week by the Centers for Medicare and Medicaid Services aims to make the nursing home industry more transparent by better informing consumers about the role private equity investors and real estate investment trusts play in the sector. In addition to disclosing ownership, any nursing home owner accepting Medicare or Medicaid would be required to list trustees and companies that provide administrative, clinical and financial services. The rule will take effect in mid-January. (Eastabrook, 11/20)

In other industry developments —

Modern Healthcare: Guidehouse: Cybersecurity Ranks Ahead Of AI For IT Budgets
Healthcare is grappling with one of the most challenging years for cybersecurity on record, so health system C-suite executives are making data security solutions a budget priority. Consulting firm Guidehouse surveyed health system CEOs and chief financial officers about their top three IT investment priorities in 2024. Improvements to cybersecurity ranked ahead of any other potential budget item, including upgrades to artificial intelligence and electronic health record systems. (Perna, 11/20)

CIDRAP: Hospital Execs See Worsening Antibiotic-Resistance Threat, Survey Finds
A new survey of 158 hospital executives, conducted by the Sepsis Alliance, found that 90% see antimicrobial resistance (AMR) as a threat, and 88% think the problem is getting worse. The survey, conducted by Sage Growth Partners on behalf of the Sepsis Alliance, also dug into executives' views on other related AMR issues. An 11-page report on the findings was published on the Sepsis Alliance website on November 17. (Schnirring, 11/20)

Politico: AstraZeneca Launches Digital And AI Business For Clinical Research
AstraZeneca is moving to capture a relatively untapped market for digital and AI solutions for clinical trials by launching a new health tech business. The company, called Evinova, will sit within AstraZeneca but offer services to other pharma companies that are traditionally competitors of the British-Swedish pharma giant. On offer are products that use AI to help with clinical trial study design; a clinical trial solution that supports the collection of endpoint data; and a tool to manage and track clinical trials. (Furlong, 11/20)

In industry legal news —

Politico: NYU Langone Cancer Center Director Sues Over His Firing
A fight between NYU Langone Health and the well-known director of its prestigious Perlmutter Cancer Center is spilling out into the open. Benjamin Neel filed suit against the health system Friday because of its decision to terminate his contract over several social media posts about the Israel-Hamas war that he reshared on X, formerly known as Twitter. (Kaufman, 11/20)

Reuters: Texas AG Sues Pfizer Over Quality-Control Lapses In Kids' ADHD Drug
Texas Attorney General Ken Paxton accused Pfizer (PFE.N) and its supplier Tris Pharma of providing children's ADHD medicine that it knew might be ineffective to the state's Medicaid insurance program for low-income people, in a lawsuit unsealed on Monday. The lawsuit, filed in Harrison County, Texas District Court, alleges that Pfizer and Tris manipulated quality-control testing for the drug Quillivant XR in order to obtain passing results from tests it was required to perform under federal law between 2012 and 2018. Properly done tests frequently showed that the drug failed to dissolve as it was supposed to, a sign that it would not be released in the body as expected, the lawsuit said. (Pierson, 11/21)

Also —

KFF Health News: Out For Blood? For Routine Lab Work, The Hospital Billed Her $2,400
Reesha Ahmed was on cloud nine. It was January and Ahmed was at an OB-GYN’s office near her home in Venus, Texas, for her first prenatal checkup. After an ultrasound, getting anti-nausea medication, and discussing her pregnancy care plan, she said, a nurse made a convenient suggestion: Head to the lab just down the hall for a standard panel of tests. (Pradhan, 11/21)