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Actress Angelina Jolie made headlines around the world last May when she wrote an op-ed in The New York Times describing how she elected to have a preventive double mastectomy based on the results of genetic tests.  Her decision cast genetic and genomic testing into the spotlight, and widescale product development may soon fuel new patient inquiries-a lot of them.

Genetic testing's brave new world

Discover the strategies that are transforming healthcare practices.

 Learn how top practices are using innovative solutions to optimize patient engagement, reduce costs, and increase revenue. Our comprehensive guide, 

"HealthTech Survey: What Specialty Practices are Using to Fuel Profitability,"

 reveals the latest trends and best practices in healthcare technology. 

 to gain valuable insights and unlock the potential of your practice.

Fill out the form below to download the guide:

HealthTech Survey: What Specialty Practices Use to Fuel Profitability 

Reflecting the soaring growth of concierge medicine, the Concierge Medicine Forum (CMF) in Atlanta is now one of the year’s most highly anticipated conferences. For the first time, Medical Economics has partnered with Specialdocs to bring you in-depth coverage of the industry’s premier event, now in its 10th year.

Start with our video series designed to give you a sneak peek of intriguing sessions on the CMF agenda. Take a few minutes to learn about:

Concierge medicine’s auspicious beginnings and exceptionally bright future from Specialdocs CEO Terry Bauer and conference organizer Michael Tetreault. 

Ups and downs of being “married to medicine” from spouses who’ve worked side by side to successfully convert to a concierge practice. (Coming soon!)

How to determine the best time to make a change to concierge medicine from three physicians at very different stages in their career. 

The critical role of concierge doctors in detecting and preventing cardiac disease. 

 to register with promo code “FORSPECIALDOCS” and receive an exclusive 15% discount.

After the conference, check back here for 

 featuring highlights and insights from industry thought leaders and practitioners, all dedicated to changing healthcare for the better, one patient at a time.

Reflecting the soaring growth of concierge medicine, the Concierge Medicine Forum in Atlanta is one of the year’s most highly anticipated conferences. 

This year’s don’t miss event: The Concierge Medicine Forum, October 17–19, 2024 

The best time to make a career change to concierge medicine

When is the best time to make a change to concierge medicine? Three physicians reveal their personal turning points at very different stages in their career, and how to know when converting to a concierge model may be your next best move.

 that shifts the focus from the volume of services provided to the quality of care delivered. This paradigm shift aims to improve patient outcomes, reduce costs, and enhance the overall efficiency of the health care system. 

, as one of the largest health care payers in the United States, has played a pivotal role in implementing VBC initiatives.

One of the key advantages of VBC for Medicare is its potential to reduce health care costs. By 

 to deliver high-quality care efficiently, VBC can help curb unnecessary procedures, hospitalizations, and other costly medical interventions. This can lead to significant savings.

Another important benefit of VBC is its emphasis on improving patient outcomes. By focusing on quality rather than quantity, VBC encourages providers to deliver personalized care that addresses the specific needs of each patient. This can create positive health outcomes, increased patient satisfaction, and reduced readmission rates.

Medicare has implemented various VBC programs, including 

 (ACOs), bundled payments, and Comprehensive Primary Care Plus (CPC+) models. ACOs have gained significant traction as they bring together providers and hospitals to coordinate care and share in the financial risks and rewards.

While VBC has shown promising results, challenges remain. Implementing VBC requires a significant cultural shift within the health care industry, as it necessitates a move away from fee-for-service models. Additionally, there are concerns about the potential for disparities in care quality among different patient populations.

Value-based care represents a significant step forward in transforming the Medicare program. It has the potential to deliver substantial benefits to both beneficiaries and the health care system. As Medicare continues to expand and refine its VBC initiatives, it is crucial to address the challenges and capitalize on the opportunities to create a more sustainable and patient-centered health care system. To learn more, look at this slideshow created from an Aledade infographic.

Ahmed Haque leads Network Performance & Strategy at

, overseeing performance and shared savings across Accountable Care Organizations. He has 15+ years in healthcare, previously working at the U.S. Department of Health & Human Services, National Quality Forum, and the American Hospital Association.

Incentivizing high-quality care reduces costs while improving patient outcomes.

Topics

Value-based care: Transforming Medicare for the better

By 2050, it's estimated that 139 million people worldwide will have dementia, but by today's standards, 60% will be undiagnosed. It's clear that there's a significant gap in dementia detection and care, but what can your organization do about it?

Get perspectives from clinical leaders and neuroscience experts about the underlying causes and consequences of these gaps, practical opportunities to address them, and a proven roadmap that shows how leading health systems have successfully transformed their dementia screening and care processes.

Resources

Closing the Dementia Care Gap: Expert Insights and Proven Strategies for Health Systems

Smaller and medium-sized physicians’ practices and other medical service providers were 

The CEO of its corporate parent said he wants to help them stay afloat.

On May 1, UnitedHealth Group CEO Andrew Witty testified in the House of Representatives Energy & Commerce Committee Oversight and Investigations Subcommittee 

, "Examining the Change Healthcare Cyberattack." It was the second of his doubleheader of congressional testimony. Earlier in the day, he spoke about the Feb. 21 hack in a 

Based on more than two hours’ worth of questions from House Committee and Subcommittee members, it appears they, along with physicians and other health care providers, are suspicious about UnitedHealth Group’s connectivity and willingness to help.

UnitedHealth Group has invested about $300 million in cybersecurity, Witty said, and smaller and medium-sized health care businesses around the country have nowhere near that much to spend on it.

, call center at 1-866-262-5342, and interest-free, no-fee loan program meant to help physicians and other clinicians. The company has paid more than $6.5 billion in accelerated payments and the loans to about 142,000 tax identification numbers (TINs). An exact number of providers was not available because the number varies and they can move from TIN to TIN, but that does represent about one-third of all provider TINs associated with Change Healthcare before the attack, he said in questioning by Rep. Mariannette Miller-Meeks, MD (R-Iowa).

“So, very substantial uptake, very large fraction of those folks are small providers,” Witty said, with UnitedHealth Group “essentially auto-approving loans to small providers in matter of hours.”

That program remains open, and Witty acknowledged the company botched the first week or two of the loans. The lawmakers offered anecdotes of constituent physicians or other health care providers at first getting a few hundred or thousand dollars to sustain businesses that needed substantially more to maintain cash flow.

The company still is determining whose health or identifying information may be posted online. It may be up to one-third of the American population, Witty said. UnitedHealth Group will accept all responsibility for notifying people, he said.

A number of the lawmakers, including some of the physicians, asked about the cyberattack and hammered on the connections to continuing consolidation in health care.

Subcommittee Chair Rep. Morgan Griffith (R-Virginia) opened the hearing with that issue.

“How could something like this happen?” he said. “How did consolidation in the health insurance industry reach such a state that a single ransomware attack on one company can cripple the flow of payments and claims for months?”

“I firmly believe that consolidation in health care is not a good thing, OK?” said Rep. Larry Bucshon, MD (R-Indiana). “It's led to increased costs. We know that. Even though everybody says it will decrease costs, it does not.”

Rep. Kim Schrier, MD (D-Washington), said she was on the same wavelength as Bucshon regarding consolidation and its effects on patients and physicians.

“The reality is that this massive, far-reaching attack has disproportionately impacted small, independent practices that were already struggling to stay afloat and United's advanced payments have been appreciated, but insufficient, and other payers, as you've just heard, have done nothing to help. It is in their interest to hold on to that money,” she said. She offered the example of a small physical therapy practice in Washington where the owners had to mortgage their house to make rent and payroll, while UnitedHealth Group posted $371 billion in revenue in 2023.

Committee Chair Rep. Cathy McMorris Rodgers (R-Washington) called UnitedHealth the “poster child” of arrangements of insurers not trying to pay for patient care and maintaining ownership over doctors that are supposed to provide it. Rep. Buddy Carter (R-Georgia), a career pharmacist, displayed a literal poster that diagrammed UnitedHealth Group’s business interests sprawling across health care, and asked Witty about how his company can justify clear conflicts of interest.

“Thank you for the question and the challenge. I appreciate that,” Witty said. “We operate our organization with very clear firewalls between the organization and we are guided around a mission of trying to align incentives in the system to try and eliminate waste and abuse and to try and deliver value-based care to individuals. We know that when that happens, clinical outcomes improve and we believe the cost goes down for people involved in that process. That's what we focus on through the organization.”

UnitedHealth Group offered prior authorization flexibilities after the attack. Now physicians and other health care providers who took advantage of those now fear they could be subject to cumbersome audits or that UnitedHealth Group might second-guess some of the decisions users had to make while the systems were down, said Rep. Raul Ruiz, MD (D-California). He asked for assurance that UnitedHealth Group would not pursue unfair retroactive denials and clawbacks, and Witty agreed.

Rep. John Joyce, MD (R-Pennsylvania), asked why PA flexibilities for Medicare Advantage plans were not extended for other insurance, but Witty noted Medicaid decisions generally are left to states, and employers offering private insurance generally make their own rules regarding PA.

Rep. Kat Cammack (R-Florida) said providers who have taken loans to cover revenue shortfalls have said they felt pressured by UnitedHealth Group to make upbeat public statements about the support. Rather, Witty noted UnitedHealth Group staff asked providers who received loans to spread the word about the program, but upbeat public statements are not part of any approval criteria for the loans.

Apart from physicians, patients, pharmacists and other health-related effects, Rep. Michael Burgess, MD (R-Texas), encouraged Witty to continue working with law enforcement to find the culprits.

“I want to see someone arrested and marched into the center of town and shot for doing this,” Burgess said. Witty praised the efforts of the FBI and agreed with Burgess’ sentiment.

“I am completely aligned with you that I'd love to see these people brought to justice,” Witty said. “And I hope we're the last people they ever attack.”

Following testimony in Senate, UnitedHealth Group CEO Witty appears before House oversight subcommittee.

Mark Crane

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