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Morning Briefing

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Monday, Oct 18 2021

Full Issue

Walmart Partners With Transcarent, Entering Self-Insured Market

Meanwhile, reports say New Orleans-based Ochsner Health is the first hospital system in Louisiana to have its own insurance arm. East Orange General Hospital, Lee County Hospital, Northeast Georgia Health System, health data leaks from security flaws in third-party apps, and more are in the news.

Walmart is making its first foray into the self-insured employer market through a new partnership with healthcare startup Transcarent, the retailer announced Friday. Employers that contract with Transcarent will share any cost savings that result from workers using Walmart expanding suite of healthcare services, which includes in-person clinics, discounted prescription drugs, virtual care, vision care and specialty medications. In addition to shared savings, Walmart stands to benefit from additional customers in its stores.Transcarent currently has 100 self-insured employer clients and serves more than 1 million employees. Among the company's offerings are expert second opinions, medication reviews, and referrals to surgery sites and centers of excellence. (Gillespie, 10/15)

In other health care industry news —

New Orleans-based Ochsner Health System is the first hospital system in Louisiana to create its own health insurance arm selling Medicare Advantage policies. Ochsner's Medicare Advantage plans include prescription drug coverage, fitness, dental, hearing and vision. Ochsner's premiums and copays begin at $0. The Medicare Advantage plan is integrated into the health system, according to the hospital network. Before rolling out statewide, Ochsner wants to sell plans in the New Orleans and Baton Rouge region, which includes the following parishes: Ascension, East Baton Rouge, East Feliciana, Iberville, Jefferson, Lafourche, Livingston, Orleans, St. Charles, St. John the Baptist, St. Tammany and West Baton Rouge. (Mosbrucker, 10/17)

East Orange General Hospital in New Jersey is changing ownership, the for-profit company announced Friday. Paige Dworak, who will be the first female owner-CEO of a New Jersey hospital, will continue to lead operations and assume a 20% ownership stake. EOH Acquisition Group, the new owners, aim to stabilize the struggling hospital, which has reported operating losses the last two years. "We are so excited about the future of this historic hospital and its impact on the community," Dworak, who has led the 201-bed hospital since 2017, said in a news release. "The change in ownership will help accelerate the transformation of this vital community asset, ensuring the hospital continues to deliver the quality care the patients and the community have come to rely on for over a century." (Kacik, 10/15)

Billy Mathis admits that the challenge presented to the Lee County officials and private individuals who remain hell-bent and determined to build a hospital in the county is a daunting one ... actually, an insurmountable one. Talking about the glimmer of hope that the Department of Public Health gave partners in the Lee County Medical Center venture by granting a six-month extension on the project, Mathis conceded that the DCH had asked for the impossible. (Fletcher, 10/16)

Even after the COVID-19 pandemic calms, the Northeast Georgia Health System plans to increase its critical care capacity. The health system was forced to serve patients in unconventional places during the biggest waves of the pandemic, including providing care in the back of ambulances, in hallways and in outdoor mobile units. COVID-19 numbers in the health system have dropped in recent weeks from a Sept. 9 peak of 333 COVID-19 positive patients, influenced by the delta variant. As of Friday, Oct. 15, there were 127 COVID-19 patients in the health system, with 36 patients waiting for test results. (Evans, 10/15)

Also —

In the last year, cyberattacks on hospitals have surged, putting a spotlight on the need to protect patients’ health data. But hackers don’t need to attack providers directly to get that valuable info. A new cybersecurity report shows it is remarkably easy for bad actors to steal it through third-party apps and data aggregators that tap into providers’ electronic health record systems. (Palmer, 10/18)

Artificial intelligence tools in health care should be safe and effective. They should be fair to people of different races, genders, and geographies. And they should be monitored to ensure they are improving outcomes in the real world. Most participants agreed on those goals in a Food and Drug Administration workshop on the regulation of artificial intelligence late last week.  But how to accomplish them remained a source of considerable debate. (Ross, 10/18)

Eren Bali’s first “unicorn,” online course marketplace Udemy, is readying an IPO. Meanwhile, Carbon Health, his other company, is helping people in the U.S. get vaccinated and tested for COVID-19 — on top of running 83 clinics in 12 states. Bali isn't a household name, but he's quietly built two companies that were perfectly poised to fill in gaps created by the pandemic. (Kokalitcheva, 10/16)

KHN: ‘An Arm And A Leg’: Hello? We Spend 12 Million Hours A Week On The Phone With Insurers 

After Stanford professor Jeffrey Pfeffer got back surgery years ago, he kept a file folder labeled “Blue Shield Troubles.” When Pfeffer got an offer to collaborate with the polling company Gallup, he suggested a study on how much time Americans spend on the phone with their health insurers. Gallup agreed. Their finding: We spend about 12 million hours a week calling our health insurance. (Weissmann, 10/18)

In obituaries —

Jose Russo, 79, a Fox Chase Cancer Center physician and scientist who was acclaimed for his research on reducing the risk of breast cancer, died Friday, Sept. 24, at home in Rydal. Dr. Russo worked until a week before his death, when he became too weak from his own bout with cancer of the stomach, said his daughter, Patricia A. Russo. Dr. Russo spent decades studying how various synthetic chemicals may increase the risk of breast cancer and why the risk is reduced in women who have babies in early adulthood. (Avril, 10/18)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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