On Sept. 1, UnitedHealthcare is set to begin a two-phased approach to eliminate prior authorization requirements for several procedure codes, including three gastroenterology-related codes. The code removals will account for almost 20 percent of its overall prior authorization volume. On Sept. 1 and Nov. 1, codes will be eliminated for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plans. On Nov. 1, codes will be eliminated for the UnitedHealthcare Community Plan as well.
Author: Rutali Thakur
ATLANTA, Aug. 15, 2023 /PRNewswire/ — United Digestive (UD), a leading provider of comprehensive GI services, is excited to announce a new agreement with a prominent market exchange payer in Georgia, marking a significant milestone in the company’s growth and commitment to patient-centric care. Effective July 1, UD entered a partnership with Oscar Health, Inc., extending its services to more than 90,000 patient lives. This strategic expansion allows UD to reach a broader population and positively impact even more patients through the inclusion of endoscopy centers, infusion services, and anesthesia. The partnership ensures that UD’s exceptional services remain accessible to those in need.
No-moat Guardant Health GH posted strong second-quarter results that were about in line with our expectations. Solid volume growth drove revenue up 26% year over year and pushed management to lift full-year guidance. While we have slightly raised our full-year 2023 revenue growth forecast on a strong first-half performance, we maintain our longer-term growth assumptions, and therefore there is no material change to our $63 fair value estimate. Shares remain significantly undervalued at current prices.
Running a primary care practice is no easy feat. Between no-show appointments, combating negative reviews, staffing shortages, and tightening reimbursements, physicians and administrators have a lot on their plates. When these issues go unresolved, they bring severe financial pressures that can affect a health care provider’s bottom line.
Surgery did not significantly increase the number of “good days” among patients with advanced cancer and malignant small bowel obstruction, according to study results. However, patients who underwent surgery reported improvement in malignant bowel obstruction-related symptoms by 3 months after trial registration, findings published in The Lancet Gastroenterology & Hepatology showed.
The American College of Physicians (ACP) issued updated guidance for colorectal cancer screening for asymptomatic, average-risk adults that suggests starting screening at age 50. The guidance is based on a critical review of existing clinical guidelines and evidence reviews and modeling studies used to develop those guidelines. The guideline is published in Annals of Internal Medicine.
IRVINE, Calif., Aug. 03, 2023 (GLOBE NEWSWIRE) — Biomerica, Inc. (Nasdaq: BMRA) (the “Company”) today announced that CVS Pharmacy has begun in-store sales rollout of the Company’s EZ Detect™ colorectal disease screening test in over 7,000 stores nationwide throughout the CVS Pharmacy retail system. Biomerica has shipped the EZ Detect product to CVS Health distribution centers in the US, and the product is projected to be on store shelves in September. The Company is also working with CVS Health to introduce an additional Biomerica product to be sold in CVS pharmacies.
The Senate and House have reintroduced the bipartisan Treat and Reduce Obesity Act (TROA) (H.R. 4818/S. 2407). This legislation is a vital first step in expanding access to obesity treatment as it would expand Medicare coverage to include screening and treatment of obesity by a diverse range of health care providers who provide obesity care. The bill also includes coverage of behavioral counseling, prescription drugs for long-term weight management, and other prevention and treatment options.
Outsourcing certain staff functions in a practice to outside contractors working in remote locations has become commonplace in many medical practices. Healthcare outsourcing services, also known as virtual assistants (VAs), were already booming in 2017, when volume grew by 36%. Then, the COVID-19 pandemic in 2020 normalized offsite work, which was a boon to outsourcing providers. The most popular services being outsourced today by medical practices include billing, scribes, telephone calls to patients, and processing prior authorizations.
The phenomenon of private equity (PE) companies purchasing medical practices is receiving greater scrutiny from academicians, journalists, and government regulators. Many recent stories do not portray the private equity model in a favorable light. As I discussed in an earlier Forbes piece, under the private equity model an investment fund purchases a medical practice. The current physician owners receive some combination of cash and/or stock in the larger entity (often with a vesting period and other restrictions such as a non-disparagement clause if they leave the practice). In exchange, they work as employees for the new owners, who set business policy. The new…