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Health Tech | Fierce Healthcare Daily Digest (Unofficial)

 

(https://www.fiercehealthcare.com/ai-and-machine-learning/microsoft-collaborates-mass-general-brigham-university-wisconsin-ai-medical) Microsoft, Mass General developing AI models for radiology
Jul 24th 2024, 13:31

Microsoft continues to deepen its work in healthcare AI. The tech giant is now collaborating with academic medical systems Mass General Brigham and the University of Wisconsin-Madison to advance AI in medical imaging.
The aim is to develop, test and validate AI algorithms and applications that improve the accuracy and consistency of medical image analysis and enable healthcare organizations to build medical imaging AI copilots, the organizations said.
Researchers and clinicians at Mass General Brigham, UW School of Medicine and Public Health, and UW Health will work with the tech company to advance state-of-the-art multimodal foundation models. Microsoft and the partner health systems will research how these algorithms and applications can help radiologists and clinicians interpret medical images and assist with report generation, disease classification and structured data analysis, according to the organizations.

The AI models will be built on top of the Microsoft Azure AI platform and integrated into clinical workflows via Nuance’s PowerScribe radiology reporting platform, which is used by a majority of U.S. radiologists, and Nuance’s Precision Imaging Network. 

The collaboration includes UW School of Medicine and Public Health along with its partnering health system, UW Health. 
Medical imaging plays a critical role in healthcare and medical diagnoses. Health systems spend an estimated $65 billion each year on imaging, according to a J(https://pubmed.ncbi.nlm.nih.gov/22692172/) AMA study. Approximately 80% of all hospital and health system visits include at least one imaging exam related to more than 23,000 conditions, Definitive Healthcare data shows.
The healthcare industry is grappling with rising rates of physician burnout and staffing shortages. Many hospitals and health systems are exploring generative AI tools to help reduce workloads, enhance workflow efficiencies and improve the accuracy and consistency of medical image analysis for care delivery, clinical trials recruitment and drug discovery.

"Generative AI has transformative potential to overcome traditional barriers in AI product development and to accelerate the impact of these technologies on clinical care. As healthcare leaders, we need to carefully and responsibly develop and evaluate such tools to ensure high-quality care is in no way compromised," said Keith J. Dreyer, D.O., Ph.D., chief data science officer and chief imaging officer at Mass General Brigham and leader of the Mass General Brigham AI business, in a statement.

"Foundation models fine-tuned on Mass General Brigham's vast multimodal longitudinal data assets can enable a shorter development cycle of AI/ML-based software as a medical device and other clinical applications, for example, to automate the segmentation of organs and abnormalities in medical imaging and increase radiologists' efficiency and consistency," Dreyer said.
Scott Reeder, M.D., Ph.D., chair of the Department of Radiology, University of Wisconsin School of Medicine and Public Health, and radiologist at UW Health, said the collaboration with Microsoft will advance "development, validation and thoughtful clinical investigation of generative AI in the medical imaging space."
"Our focus is to bridge the gap within medical imaging from innovation to patient care in ways that improve outcomes and make innovative care more accessible," Reeder said.
Microsoft also is working with chipmaker Nvidia to (https://www.fiercehealthcare.com/ai-and-machine-learning/nvidia-inks-tie-ups-abridge-ge-healthcare-and-microsoft-it-expands-its) advance the use of generative AI, the cloud and accelerated computing to healthcare and life sciences organizations. The two companies announced a collaboration in March to bring together the advanced computing capabilities of Microsoft Azure with Nvidia DGX Cloud and the Nvidia Clara suite of computing platforms, software and services, the companies said.

(https://www.fiercehealthcare.com/health-tech/oncs-micky-tripathi-creating-connected-healthcare-system) ONC’s Micky Tripathi on creating a connected healthcare system
Jul 24th 2024, 13:31

(https://www.fiercehealthcare.com/health-tech/headway-banks-100m-series-d-round-eyes-expansion-medicare-advantage-and-medicaid) Headway banks $100M series D, doubling valuation to $2.3B
Jul 24th 2024, 13:31

New York City-based Headway built a platform to make it both easier for patients to find a therapist and easier for therapists to accept insurance.
The startup has seen rapid growth, now operating in all 50 states and has 34,000 in-network mental health care providers affiliated with more than 40 insurance plans. That's up from 26,000 providers and 19 in-network insurance plans just last October when the company announced its (https://www.fiercehealthcare.com/health-tech/new-mental-health-unicorn-headway-lands-125m-build-out-therapist-networ) $125 million series C funding round.
Headway says it powers an average of 600,000+ therapy appointments per month.

The company streamlines credentialing, onboarding, clinical training, scheduling, billing and more, making it easy for mental health clinicians to accept patients through insurance.
Nine months after its series C round, Headway secured $100 million in series D funding, boosting its valuation to $2.3 billion, a 130% increase from its previous valuation, according to Headway executives. The startup has raised more than $321 million to date.
Headway has "clear line of sight to company-level profitability,"  Andrew Adams, founder and CEO of Headway, told Fierce Healthcare via email. Headway's revenue has more than doubled in the past 12 months. 
"At our scale, that makes us among the fastest-growing companies in the U.S. In this capital market, being world-class at growth is not enough; we’re also world-class efficient, in terms of unit economics," he noted.

Spark Capital led the series D round, with participation from existing investors Thrive Capital, Accel and a16z, and new investor Forerunner Ventures.
Headway will use the fresh capital to fuel product development, grow its partnerships with commercial plans and accelerate its planned expansion to Medicare Advantage and Medicaid, Adams said.

The expansion will enable clinicians to provide affordable, effective mental health care to a broader and more diverse community of patients, including seniors, low-income Americans and individuals living with disabilities, he noted.
"There is a rampant need for increased access to mental health care services among these populations, and our community of clinicians overwhelmingly want to fill the gaps. When we surveyed providers on our platform last year about this topic, they said that the number-one reason they took insurance was to 'provide access to care for those that may not be able to afford private pay services'," he said.
In a survey of more than 1,000 clinicians conducted by the company last year, a majority reported that the top reason they took insurance was to "provide access to care for those that may not be able to afford private pay services," the company said.
Headway is building the "nuanced products and programs required to enable clinicians to accept patients from these plans," Adams noted.
Headway expects to be live with Medicare Advantage in all 50 states and Washington, D.C. by the end of the year, and live with Medicaid in 2025. 
Medicare Advantage and Medicaid cover more than 100 million Americans — nearly one-third of Americans — who often experience higher rates of need.  A March 2024 report from the U.S. Department of Health and Human Services says that despite the fact that one in three Medicaid beneficiaries and one in four Medicare beneficiaries live with a mental illness, access remains elusive due to a dire shortage of mental health providers. There are not enough mental health providers who can currently serve them.
"Government programs have an additional layer of operational burden, such as more complex credentialing processes and stricter compliance requirements, when compared to commercial plans," he said. "We’re investing in the technology to relieve this operational and administrative burden, and ultimately make it easy for clinicians to deliver care to these patients. This expansion will have a profound impact on populations we previously couldn’t serve at scale, as well as the 34,000 clinicians who actively use our platform to run their private practice." 
There is growing demand for mental healthcare in the U.S., but many people fail to find care because they can't afford to pay for services out-of-pocket.
Adams faced these barriers after he moved to New York City and tried to find a therapist, he told Fierce Healthcare in 2020.
"I couldn’t find a therapist that I could afford because 70% of therapists don’t accept insurance," Adams said in a (https://www.fiercehealthcare.com/tech/mental-health-startup-headway-nabs-26m-backed-by-google-thrive-capital) previous interview. "The reality is that therapists would accept insurance if it weren’t so hard."
He co-founded New York City-based Headway to address accessibility and affordability issues for mental health care services.

Headway’s unique approach to making the mental healthcare system more connected and equitable has really resonated in the market. Adams noted."We built something that works with therapists, that works with patients, that works with payers, rather than working around some of those segments," he said.
Since Headway's last fundraise in October 2023, the company has grown its community of providers by more than 30%, and more than doubled its number of in-network health plans.
"Our strategy of putting providers at the center of our strategy has clearly paid off; they love working with Headway and often refer their colleagues. Over the past 12 months, more than half of our new providers came from a referral," Adams said.
Headway plans to invest in building new tools and products that expedite Medicare and Medicaid credentialing timelines and compliance requirements for clinicians.
"Headway has made working with Medicare easier for me through enrollment, onboarding and navigating compliance expectations. I can truly say that I would not be accepting Medicare clients without Headway,” said Andre Maxie, LMFT, an early adopter of Headway’s Medicare Advantage expansion. “Accepting Medicare is important to me because it allows me to reach a population that has been historically underserved.”

(https://www.fiercehealthcare.com/payers/pharmacies-providers-sue-change-healthcare-over-cyberattack) Pharmacies, providers sue Change Healthcare over cyberattack
Jul 24th 2024, 13:31

A key pharmacy organization along with dozens of providers have filed a class action lawsuit over the cyberattack on Change Healthcare that caused significant disruption across healthcare.
The National Community Pharmacists Association leads the lawsuit, which was filed late Friday against UnitedHealth Group, Optum and Change. The goal is to recover losses incurred due to the attack's disruptive effects. NCPA and the provider plaintiffs also argue that Change did not take "reasonable precautions" to defend against such a breach.
The lawsuit alleges that Change clients were thereby misled about the company's network security and then when the attack led to significant financial losses, they were never reimbursed for services as they tried to navigate the downed system.

B. Douglas Hoey, NCPA CEO, said in (https://ncpa.org/newsroom/news-releases/2024/07/22/ncpa-leads-retail-pharmacy-class-action-suit-against-change) a press release that the organization opposed UnitedHealth's acquisition of Change Healthcare from the get-go, and that the breach "proves that bigger is not better."

“UnitedHealth Group and its subsidiaries need to be held accountable for their lax security measures and for their failure to provide our members with adequate support and assurances to alleviate the financial losses our members suffered," Hoey said. "Companies are so big they cannot protect every entry point and cannot respond quickly due to internal bureaucracy. The fact issues remain unresolved is a testament to this point. This breach has cost our members a significant amount of money and time and it is still not resolved months later.” 
UnitedHealth Group had not responded to a request for comment at the time of publication.
When the breach was identified, Change Healthcare was disconnected from clients as well as the rest of UnitedHealth Group to avoid further spread. In the lawsuit, the providers and pharmacies allege that UHG did this without offering them a workable alternative, cutting off claims processing and reimbursement.
Since the breach, (https://www.fiercehealthcare.com/payers/unitedhealth-reaffirms-guidance-it-posts-42b-q2-profit) UnitedHealth has paid out $9 billion in advanced payments and interest-free loans to providers, according to its second-quarter earnings last week.
“Community pharmacies incurred the losses because they wouldn’t let their patients suffer,” Hoey said. “Senior citizens and people with chronic illnesses were especially vulnerable. They can’t afford to pay out of pocket for drugs that can cost thousands of dollars because a medical billing firm left itself vulnerable."

“It wouldn’t have been fair to patients, and it isn’t fair to leave pharmacies holding the bag.”


Forwarded by:
Michael Reeder LCPC
Baltimore, MD

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