Morning Briefing
Summaries of health policy coverage from major news organizations
Sen. Cassidy Accuses Doc Association Of 'Abusing' CPT Coding System
The top senator on healthcare policy is taking a hard look at the American Medical Association鈥檚 鈥渁nti-patient and anti-doctor鈥 handling of the healthcare system鈥檚 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鈥檚 leading physician association for 鈥渁busing鈥 the Current Procedural Terminology (CPT) coding system and said he will be 鈥渁ctively reviewing鈥 the issue. (Muoio, 10/8)
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 鈥渄owncoded鈥 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 鈥
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)
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)
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)
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鈥檚 portfolio, according to a Wednesday news release. (Hudson, 10/8)
Allara Health, a virtual women鈥檚 health provider, has expanded to all 50 states. The provider, specializing in women鈥檚 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)
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鈥檚 mother who used to live in Lake Forest. (Schencker, 10/8)
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 鈥
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)
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鈥檚 annual Research Symposium. (Cerutti, 10/7)