Morning Briefing
Summaries of health policy coverage from major news organizations
Sen. Cassidy Accuses Doc Association Of 'Abusing' CPT Coding System
Fierce Healthcare: AMA's Handling Of CPT Codes Enters Congress' Crosshairs
The top senator on healthcare policy is taking a hard look at the American Medical Association’s “anti-patient and anti-doctor” handling of the healthcare system’s near-ubiquitous billing and claims processing codes. Bill Cassidy, M.D., R-Louisiana, who chairs the Senate Health, Education, Labor and Pensions (HELP) Committee, chastised the nation’s leading physician association for “abusing” the Current Procedural Terminology (CPT) coding system and said he will be “actively reviewing” the issue. (Muoio, 10/8)
Modern Healthcare: Why Aetna, Cigna's Downcoding Policies Alarm Providers
Physicians and hospitals are up in arms about new tactics some health insurance companies are using to reduce payments. Under a policy Cigna is rolling out this month, six Current Procedural Terminology Evaluation and Management billing codes are being “downcoded” through an automated process that results in lower reimbursements for services such as office visits and outpatient consultations. (Tong, 10/8)
More news from the health care industry —
Axios: Medicare Paid For 200K Unneeded Back Surgeries: Study
U.S. hospitals performed more than 200,000 unnecessary back surgeries on older adults that cost taxpayers $1.9 billion, according to a new analysis of Medicare and Medicare Advantage claims data. (Bettelheim, 10/9)
MedPage Today: Private Equity Tightens Its Grip On Outpatient Surgery
Amid billions of dollars of private equity investment in ambulatory surgery centers (ASCs), there is a need for greater monitoring and oversight, according to a new report. In recent years, ASCs have been reported to account for more than 60% of outpatient procedural care in the U.S. and represent an approximately $30 billion market, noted the research brief from the nonprofit Private Equity Stakeholder Project (PESP). (Henderson, 10/8)
The Wall Street Journal: Microsoft Tries To Catch Up In AI With Healthcare Push, Harvard Deal
Microsoft has a lofty goal: to become an artificial-intelligence chatbot powerhouse in its own right rather than leaning on its partnership with the ChatGPT maker, OpenAI. In an effort to steal a march on its more-advanced rivals, the company has seized on healthcare as a lane in which it believes it can deliver a better offering than any of the other major players and build the brand of its Copilot assistant. (Herrera, 10/8)
Modern Healthcare: OneOncology To Acquire Cancer Clinics From GenesisCare
Medical practice network OneOncology has acquired GenesisCare USA of Florida and is relaunching the practice as SunState Medical Specialists. The deal adds more than 100 physicians, including urologists, oncologists and surgeons, at 104 clinics throughout Florida to OneOncology’s portfolio, according to a Wednesday news release. (Hudson, 10/8)
Fierce Healthcare: Allara Health Expands Women's Metabolic Care To 50 States
Allara Health, a virtual women’s health provider, has expanded to all 50 states. The provider, specializing in women’s hormonal, metabolic and reproductive health, was in 30 states at the start of the year. Alongside news of the expansion, Allara has also published clinical outcomes data that demonstrate improvements in patient health in a health impact report. (Gliadkovskaya, 10/8)
Chicago Tribune: Lake Forest Hospital Gets A New Name, After Ken Griffin Gift
Northwestern Medicine Lake Forest Hospital is getting a new name after a donation from formerly Chicago-based billionaire Ken Griffin. The hospital will now be called Northwestern Medicine Catherine Gratz Griffin Lake Forest Hospital, after Griffin’s mother who used to live in Lake Forest. (Schencker, 10/8)
MedPage Today: Experts Push To Expand Role Of Nutrition In Medicine
Diet should be considered an important part of a patient's treatment along with medication, surgery, and other options, several experts said Wednesday at a "Food Is Medicine" meeting sponsored by Tufts University. "I would want to see, in 2030, food as a vital sign," said Sean Hashmi, MD, a nephrologist at the Southern California Permanente Medical Group in Woodland Hills. (Frieden, 10/8)
Also —
Medical Xpress: The AI Doctor Is Not Ready To See You Now: Stress Tests Reveal Flaws
Robust performance under uncertainty, valid reasoning grounded in evidence, and alignment with real clinical need are prerequisites for trust in any health care setting. Microsoft Research, Health & Life Sciences reports that top-scoring multimodal medical AI systems show brittle behavior under stress tests, including correct guesses without images, answer flips after minor prompt tweaks, and fabricated reasoning that inflates perceptions of readiness. (Jackson, 10/7)
Becker's Hospital Review: A New Model To Measure Nurses’ Economic Value
A new model aims to help hospitals and health system leaders better understand how investments in nursing contribute to financial sustainability. Researchers from the Johns Hopkins University School of Nursing in Baltimore and Marquette University College of Nursing in Milwaukee introduced the Nursing Human Capital Value Model Oct. 7, during a preview event for the American Nurses Enterprise’s annual Research Symposium. (Cerutti, 10/7)
