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Is This New Innovation The Best In The Crypto Market?

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By: Mark Fidelman

The crypto market is the wild, wild west, where things can turn south in a matter of hours. You might be smiling about your profits while sipping your morning coffee and sulking over your losses by evening.  

It’s a never-ending cycle: the investor’s journey meets crypto volatility. 

Fortunately, the market is rife with innovations—new protocols, new DeFi’s, and new tokens— designed to improve every aspect of this nascent industry. Just when you thought that Satoshi had already imagined everything under the sun for crypto transactions, along came smart contracts and the possibilities were endless.

A more recent, impactful innovation in crypto is the emergence of crypto ETFs. Just as GameFi and NFTs are shaking up the gaming and collectibles worlds, crypto ETFs provide exposure to the crypto market and, unlike individual tokens, are typically traded on stock exchanges.  It’s the best of both worlds:  investors gain exposure to the asset’s returns, with the transparency and protection that regulated markets bring.

The launch of the first crypto ETF, the ProShares Bitcoin Strategy ETF, in October 2021 opened the door to a handful of centralized ETFs, with which fund managers manage cryptos in their asset portfolios. 

Tetraguard: The first Defi ETF-like decentralized basket of tokens

All crypto ETFs are centralized like traditional funds. Except for one: Tetraguard. 

Tetraguard is the first decentralized ETF-like token in the cryptocurrency sector. It provides investors with simple access to the three of the most well-liked cryptocurrencies in a tokenized basket.

Tetraguard is made up of wrapped versions of the payment tokens Quadron (QUAD), as well as PAX Gold (PAXG), Ethereum (ETH), and Bitcoin (BTC). 

Tetraguard transactions are enabled by the liquidity of an Automated Market Maker (AMM), with Bonus Fee Tokens (QUADs) awarded to early buyers. Investors hold a diverse basket of well-known cryptocurrencies with a single transaction. Additionally, merely by holding it, they earn a portion of the shared transaction fees that occur on the platform.

Because Tetraguard is fully decentralized, trades and swaps can be conducted without interference. 

Built on the Ethereum blockchain, Tetraguard is 100% run by TETRA’s audited smart contracts. Neither you nor anyone else’s cash is accessible to a central authority. With an automated market maker and clear instructions on how to divide the reward, the wrapped coins are securely locked away in the smart contract. Tokens are burned as users decide to sell their TETRA tokens.

QUAD: Hold And Be Rewarded

The core of the Tetraguard ecosystem is the reward token. According to the whitepaper, Tetraguard is built on the QUAD, the fee and staked ETH-collecting token, located inside the TETRA. 

The safety of the procedure is predicated on the fact that the majority of the QUAD tokens are effectively kept inside the TETRA baskets. In contrast to fiat currencies, a “run” on the QUAD reserve would be extremely unlikely because the TETRA owner would have to sell their entire basket to access the QUAD.

Pros Of Tetraguard? 

Tetraguard offers many benefits to the crypto investor:

  1. The reward for holding:

Tetraguard is distinguished by its QUAD token, a fee-producing token with an infinite value rise and potential revenue stream. Tetraguard offers rewards to token holders and traders. This enables investors to receive fees devoid of a central body taking a cut.

  1. Diversify Your Investment: 

The best feature of Tetraguard is that it enables investors to trade the world’s most well-liked tokens in a single transaction, making it simple for users to take profits and reduce potential losses associated with any downswing in asset valuation.

  1. Liquidity:

On Tetraguard.io, Tetraguard gives users the option to buy and sell tokens without having to switch between exchanges. If they choose, investors can profit from a bull market or reduce exposure to a LUNA-like crash by selling out in a single transaction.

The Tetraguard protocol contains a built-in liquidity pool mechanism for its smart contracts and is therefore has liquidity regardless of whether it’s eventually listed on an exchange.

Conclusion 

Is it safe? Consensys says:  “Using Consensys MythX security analysis tools, the code for Quadron’s and Tetraguard’s Smart Contracts has been tested and reviewed and found to have zero vulnerabilities.”

Investors can increase exposure to a larger selection of cryptos with potential by investing in a variety of different tokens. By doing this, investors increase the likelihood that their investment will return a profit. 

As the crypto winter continues to sweep the market, this ETF might be the best innovation for investors who want to keep their money safe while they continue to get exposure to volatile coins. 

Mark Fidelman is a Global Marketing Executive focused on Blockchain and Security Tokens. He is the founder of SmartBlocks (a crypto marketing agency); host of the Cryptonized! YouTube show, and a popular Hackernoon contributor. With Mark’s knowledge of DeFi, he hopes to educate and inspire crypto enthusiasts about the why’s and hows of recent exploits and innovative projects focused on the tokenization of real-world assets. Previously, Mark contributed to Forbes, The Huffington Post, and Business Insider, and he is the author of the book SOCIALIZED!  

Disclaimer: This is a guest post. Coinpedia does not endorse or is responsible for any content, accuracy, quality, advertising, products, or other materials on this page. Readers should do their own research before taking any actions related to the company.

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Fed Chair Jeremy Powell all Set to Deliver his Speech-Will Crypto Market Drop Again?

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bulls and bears

U.S FED’s Chair, Jerome Powell is going to speak at the Sveriges Riksbank International Symposium on Central Bank Independence, while the crypto markets and the stock market investors are presently clueless. Most analysts believe the markets could turn extremely volatile as the Bitcoin price is expected to rise slightly and after it hits $17,500, massive liquidations may explode. 

$BTC

Jerome Powell’s speech will be in 2h 30 mins.

Be careful trading at that time as algos will be on fire reacting to his words.

If this scenario occurs and hit the liquidations at $17500 within today & tomorrow, we’ll support the idea of CPI giving us a mid-week reversal. pic.twitter.com/tdQYPbuHEe

— CrypNuevo ???? (@CrypNuevo) January 10, 2023

Previously, the markets responded in a negative way whenever the FED chair delivered his speech citing the dovish outlook. A similar trend is believed to replicate and hence the analyst here has warned his 37.8K followers to be careful in performing any trade. 

Besides, another popular analyst, Micheal van de Poppe, believes that Jerome Powell has no base to produce a dovish speech apart from having more than 50 PMI from Friday. Hence believes that the markets may just be relaxed and display no major impact of his speech. 

Aside from the <50 Services PMI from Friday, there's no real case for Powell to become dovish suddenly, while the markets are pricing it in.

I’d expect markets to cool off later today, but to rally from CPI on Thursday, expecting those to come in lower than expected.

— Michaël van de Poppe (@CryptoMichNL) January 10, 2023

Collectively, after a significant upswing, the markets are again consolidating within a very narrow range. Hence it appears that the Bitcoin and major altcoins are preparing for the event and hence began accumulating well in advance. 

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Qadir AK

Qadir Ak is the founder of Coinpedia. He has over a decade of experience writing about technology and has been covering the blockchain and cryptocurrency space since 2010. He has also interviewed a few prominent experts within the cryptocurrency space.

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SCOTT’s All New Moto Adventure Collection

SCOTT’s All New Moto Adventure Collection

SCOTT Sports is excited to introduce its all-new collection of motorcycle apparel designed for adventure. The collection features an array of new products and color options, providing riders with everything they need to embark on their next journey in style and comfort.

From scenic roads to epic trails, from hot deserts to cold mountains and everything in between, SCOTT adventure range of technical motorcycle apparel will have you covered.

SCOTT Adventure gear utilizes state-of-the-art technologies, fabrics and features. The use of market-leading technologies such as GORE-TEX, Pittards® leather, D3O®, DRYOsphere and PFC Free DWR is what sets SCOTT’s gear apart from the rest and means you can go where the road takes you, safe in the knowledge that you will be prepared for anything.


Now specifically designed for women, the top of the line, SCOTT Priority GTX is made for 3 seasons featuring wind and waterproof 3-layer GORE-TEX construction and Pittards® leather reinforcements. Equipped with D3O® protectors, the Priority GTX will take care of your safety and allow you to push your limits.

SCOTT Voyager Dryo

Born to beat the elements the SCOTT Voyager Dryo gear is as tough as it is comfortable. Now available in all new colorways, it comes with a wind and waterproof DRYOsphere membrane, is well ventilated and gives you the climate comfort you are looking for. Equipped with D3O® protectors we take care of your safety and allow you to push your limits.

Same great features – all new colors. The SCOTT Dualraid Dryo is the best choice for long adventures where durability, ventilation and comfort are a necessity. With a wind and waterproof 3-layer DRYOsphere membrane you can custom fit this jacket to any condition. Equipped with D3O® protectors we take care of your safety and allow you to push your limits.

Now with even more color options available, the SCOTT ADV Terrain Dryo gear is the perfect choice for long distance trips in varied conditions, boasting the perfect blend of comfort, durability and weather protection. Built in D3O® protectors will keep you safe, and plenty of customizable options allow you to always be prepared and focus on the adventure ahead.

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J.P. Morgan healthcare conference opens for Day 3

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Judge orders HHS to resolve 340B underpayments

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Pill bottles

Modern Healthcare Illustration / Getty Images

A federal judge Tuesday ordered the Health and Human Services Department to create a plan to correct underpayments made to 340B hospitals under a regulations the Supreme Court ruled unlawful.

In 2018, the Centers for Medicare and Medicaid Services cut 340B reimbursement by nearly 30%, which generated $1.6 billion in savings. The agency redistributed the money to all hospitals, sparking frustration among hospitals that participate in 340B. The 340B program gives these hospitals drug discounts ranging from 25% to 50%, according to the Health Resources and Services Administration.

The Supreme Court ruled in June that HHS did not have the legal authority to implement its changes to the 340B program without determining what hospitals pay for outpatient drugs. Following this decision, CMS proposed reimbursing for 340B drugs at the same rate as other medicines, stirring debate among providers.

The American Hospital Association and America’s Essential Hospitals, plaintiffs in the case, expressed dissatisfaction with Judge Rudolph Contreras of the U.S. District Court for the District of Columbia for deferring to HHS. Hospitals that lost out of 340B dollars because of the 2018 regulation had asked the court to vacate the rules and to dictate terms to HHS.

“For more than five years, the Department of Health and Human Services has unlawfully withheld vital funding from 340B hospitals that helps them provide a range of important benefits to their patients and communities. We are disappointed that the district court elected to extend this delay by remanding this case back to the department to determine the appropriate remedy,” Melinda Hatton, general counsel and secretary at American Hospital Association, said in a statement.

This is the court’s latest move to address how HHS should fix payment discrepancies from 2018 to 2022. In September, Judge Contreras ordered HHS to restore 340B payments for the remainder of 2022.


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UChicago Medicine finalizes joint venture with AdventHealth

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Two Chicago area health systems have solidified a deal to join forces and expand and improve care in the western suburbs.

The University of Chicago Medicine and AdventHealth announced today that they officially formed a “joint venture” called UChicago Medicine AdventHealth. They say the combination of their expertise and resources will allow them to bring academic medicine to more parts of the region.

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UChicago Medicine first announced its intention to form a joint venture with AdventHealth last fall when it signed an agreement to acquire a controlling interest in AdventHealth’s Great Lakes Region facilities. Today’s announcement cements the two health systems’ relationship. They say the joint venture deal officially closed Jan. 1. UChicago declined to disclose the purchase price.

UChicago Medicine now has a controlling interest in AdventHealth’s four Illinois hospitals in Bolingbrook, Glendale Heights, Hinsdale and La Grange, along with nearly 50 physician offices and outpatient locations. Each of those facilities will be co-branded and operate under the new joint name.

While UChicago Medicine has a controlling interest in local AdventHealth facilities, AdventHealth, a Seventh-day Adventist health care system based in Altamonte Springs, Fla., retains the remaining ownership stake and will continue to manage daily operations of its facilities. Both health systems will maintain a separate system-level governance and administrative staff, they say.

“With the launch of this affiliation, we are blessed to continue to build on the rich legacy of whole person care and further our mission and commitment to making these communities healthier for years to come,” Terry Shaw, president and CEO of AdventHealth, said in a statement.

The health systems expect the new venture to lead to improved outcomes for patients as physicians from both institutions partner and coordinate to deliver high-quality, value-based care.

To oversee the partnership, UChicago Medicine’s Section Chief of Gynecology Dr. Sandra Valaitis has been named chief physician for the affiliation. She will work closely with Dr. Bela Nand, chief medical officer at UChicago Medicine AdventHealth Hinsdale and La Grange, on physician collaboration, clinic integration and program development.

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“The biggest benefit of this partnership is to patients,” Tom Jackiewicz, president of the University of Chicago Medical Center, said in a statement. “AdventHealth Great Lakes’ patients now will have seamless access to UChicago Medicine’s specialty and subspecialty care and the latest clinical trials without the commute.”

The AdventHealth deal is just the latest expansion move by UChicago Medicine, which is anchored in Hyde Park and employs about 1,600 physicians. Last year, UChicago revealed plans for a new $633 million cancer center in Hyde Park, which it says would be the first free-standing cancer center in Chicago. UChicago Medicine also broke ground last year on a 130,000-square-foot multispecialty ambulatory center in Crown Point, Ind.

UChicago Medicine is among the Chicago region’s largest health systems by revenue, according to Crain’s data. It reported $2.5 billion in net patient revenue in 2021.

Meanwhile, AdventHealth operates more than 50 hospitals in nine states and employs more than 80,000 people, about 2,400 of whom are physicians.

This story first appeared in Crain’s Chicago Business.


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CVS searches for ‘the right asset’: Day 2 at J.P. Morgan 2023 healthcare conference

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The 41st annual J.P. Morgan Healthcare Conference continues for its second day at the Westin St. Francis hotel in San Francisco, where a veritable who’s who of the healthcare industry is gathered to talk pricing, patients, public policy and much more. Modern Healthcare will be providing live updates throughout the four-day event.

For more from the conference, check out:


7:45 p.m. CT: Health Catalyst shifts focus

Health Catalyst has pivoted its strategy as its health system customers focus less on long-term return on investment.

“We’ve needed to shift away from the parts of our portfolio that deliver a long-term, clinical improvement objective or long-term ROI, and focus much more specifically on near-term, hard-dollar financial improvements,” CEO Dan Burton said.

Anything that can’t help relieve financial pressures is off the table, CEO Dan Burton said. “We have to meet them where they are at,” he said. “They’re in a near-term hell.”

As part of it strategy, the healthcare data analytics and services company is expanding its outsourcing services relationships with health systems. In December, the company said it was partnering with Urbana, Illinois-based health system Carle Health to provide tech-enabled managed services in the areas of analytics, data management, reporting and project management.

The agreement also transfers employees of Carle Health’s clinical and business intelligence functions to Health Catalyst. Burton said it was a “kinder” version of outsourcing as the employees will stay local.

Health Catalyst will turn a profit this year, Burton said. The company’s goal is to generate a profit margin of 10% by 2025 through revenue streams such as outsourcing contracts and by cutting operating expenses, Chief Financial Officer Bryan Hunt said.

—Gabriel Perna


5:45 p.m. CT: Cigna raises premiums after ‘tough negotiations’

Cigna implemented a small premium adjustment this year to account for rising labor costs among providers, CEO David Cordani said.

“These are tough negotiations, back and forth, make no doubt about it, because the employer on the backend cannot afford perpetual rate increases,” Cordani said.

Cigna’s employer-sponsored insurance business, which represents 85% of its revenue, is growing, Cordani said. “We’ve been in net shared gains in the commercial space, net growth and margin expansion, which is a difficult thing to do,” Cordani said.

Medicare Advantage, which accounts for just 5% of Cigna’s business, grew in the “high single-digit range” during open enrollment for 2023, which Cigna anticipates will be in line with the industry at large, he said.

Cordani said digital services could serve as a solution to the physician shortage. After purchasing telehealth platform MDLive, Cigna rolled out a virtual-first primary care health plan for employers in some markets, and early adoption has been high, he said.

“We believe fully 40% of all healthcare will be able to delivered virtually” in the future, Cordani said.

Cigna remains interested in owning virtual care platforms, behavioral health services, specialty pharmacy and home care delivery providers, he said. The insurer is particularly interested in growing its Accredo specialty pharmacy and CuraScripts medication distribution platforms, he said.

—Nona Tepper


5:25 p.m. CT: Newly spun off GE HealthCare’s future involves a lot of AI

GE HealthCare is investing in artificial intelligence and connected devices to further embed its presence in the health system market, CEO Peter Arduini said.

The company, which spun off from General Electric on Jan. 4, is aiming to grow its AI and connected devices business, Arduini said. GE HealthCare’s biggest revenue generator is its legacy radiology and imaging equipment business, but the AI and connected devices segment is growing at a faster rate and creates recurring revenue, he said.

“This is a great business for driving cash,” Arduini said. “In the next couple of years, we won’t have any products coming out that don’t have embedded AI in them. It’s just the way things are going.”

Already, GE HealthCare has embedded AI into several applications and products, including new ultrasound and radiology devices.

“Machine learning is [being used] across the board,” Arduini said. “We want to index more towards the data because it is a great enabler for the company.”

While Arduini admitted inflation is affecting GE HealthCare’s bottom line, but said demand for its products remains strong. This is partially due to the backlog of procedures postponed during the first year of the COVID-19 pandemic, he said.

On Monday, GE HealthCare agreed to purchase Imactis, an advanced radiology equipment manufacturer. Arduini said the company will continue to be active in mergers and acquisition and will specifically seek digital ecosystem partnerships.

In advance of its fourth-quarter and full-year earnings report, GE HealthCare announced it generated $18.9 billion in revenue for 2022, a 4% increase. The imaging equipment business represented half of that revenue.

—Brock E.W. Turner


5:15 p.m. CT: Walgreens eyes growth opportunities

Walgreens Boots Alliance sees 2023 as another growth year, jump-started by the Jan. 3 closing of its $8.9 billion deal to buy Summit Health-CityMD. Its full acquisition of CareCentrix is set to close in the third quarter.

“My hope for this company and all my executive team is that you’ll see great execution out of us,” Walgreens CEO Rosalind “Roz” Brewer said. “We have built a foundation on three very strong acquisitions–the Shields business, which really supports what we need to do in our specialty pharmacy, which is one of the fastest-growing areas in pharmacy; our CareCentrix business, which is at-home care; and then the VillageMD business. We have to integrate those.”

The company hopes to achieve 30% year-over-year growth in adjusted earnings for the second half of 2023, driven in part by fewer COVID-19 headwinds and recovery in prescription volumes. Its full-year guidance, however, still projects lower earnings than 2022.

As a result of the Summit deal, Deerfield, Illinois-based Walgreens estimates it will achieve $150 million in annual efficiencies by 2027, $60 million of which will be cost savings through limited vendor contract spending, improved processes and automation. The other $90 million would stem from subsidiary VillageMD’s efforts to accelerate Summit’s transition to a more risk-based payment model, Brewer said.

The company sees opportunities to take on more risk via Medicare Advantage plans.

Walgreens is also expanding its footprint in multi-specialty care with incremental investments over the next few years and continues to build out its clinical trials business. The company plans to invest in its technology base and incorporate those tools to show how it can reduce healthcare costs. CFO James Kehoe told investors the company is open to future deals to boost its presence in population health and provider-enablement capabilities.

—Caroline Hudson


4:20 p.m. CT: Northwell expands outpatient network

Northwell Health plans to grow its ambulatory network 5% this year to nearly 900 facilities.

The nonprofit health system looks to add 22 specialty care sites, 11 primary care clinics and six urgent care facilities this year, according to the company’s presentation.

Northwell, based in New Hyde Park, New York, is building a $450 million outpatient pavilion on Manhattan’s Upper East Side that’s slated to open in the fall of 2025. The 200,000-square-foot facility will offer oncology, neurology and cardiac care as well as imaging and lab services, chronic care management and wellness services. Northwell partnered with GoHealth Urgent Care last year and expanded its Northwell Health at Home program, which provides acute care in patients’ homes.

Northwell also is diversifying its business through its for-profit venture company, Northwell Holdings.

Northwell Health formed a $100 million partnership with Aegis Ventures last year to try to improve care through digital technology. The joint venture launched a virtual care startup in November, Upliv, which partners with employers to offer telehealth services to women experiencing menopause.

At the conference Tuesday, Northwell Holdings and Aegis Ventures launched Caire, a national virtual care offering that will incrementally target a specific chronic disease, clinical indication or care gap, according to the presentation. Caire will initially focus on women’s health.

More than half of Northwell’s approximately $16.5 billion of annual revenue comes from its ambulatory business, Northwell CEO Michael Dowling told Modern Healthcare in November.

“We are moving everything out of the hospitals as much as we can,” he said. “Hospitals are one piece, a very important one, but they are not the center of the universe anymore.”

—Alex Kacik


2 p.m. CT: Clover Health reports flat Medicare Advantage sign-ups

Clover Health expects to start the year with the same number of Medicare Advantage members as last year, the company disclosed in a news release ahead of its J.P. Morgan Healthcare Conference presentation Tuesday.

That means the insurance company likely lost a net of more than 8,000 Medicare Advantage customers during open enrollment for 2023. The insurtech reported 88,136 Medicare Advantage members as of Sept. 30, up from 80,283 at the beginning of last year.

“During the most recent Medicare Advantage enrollment period, we intentionally priced our insurance plans with profitability in mind as opposed to growth,” CEO Andrew Toy said in the news release. “Due to this strategic shift, we expect to start 2023 with insurance membership approximately in line with our insurance membership as of Jan. 1, 2022.”

Clover Health anticipates generating $1.2 billion in insurance revenue this year. The company aims to spend up to 91% of premiums on patient care, slightly higher than the 85% medical loss ratio required under federal law.

Toy also reiterated Clover Health’s plan to streamline its clinician partners for the Medicare Accountable Care Organization REACH program “in connection with an increased prioritization of profitability.”

Clover Health does not need to raise outside capital, Chief Financial Officer Scott Leffler said in the news release. “We also continue to feel comfortable with the company’s current liquidity position, which helps to insulate us against a challenging market environment,” he said.

—Nona Tepper


12:45 p.m. CT: Fresenius to shrink clinic footprint

Fresenius Medical Care plans to close some of its U.S.-based dialysis clinics in 2023 as its patient volumes continue to decline.

Year-over-year, the Germany-based dialysis chain treated 1% fewer patients through the nine months ended Sept. 30 across its approximately 2,700 U.S. clinics. Fresenius will shrink its clinic footprint and expand its home care network as it grapples with higher supply chain costs, elevated labor expenses and ongoing COVID-19 challenges, said Helen Giza, who took on the CEO role in December.

“We know we need to improve profitability and optimize our portfolio,” Giza said.

Fresenius plans to trim its clinic footprint in the U.S. and “take a hard look” at its international markets as the company sees its patient volumes decline, she said.

Competitors also experienced a decline in dialysis patients, likely indicating that more patients were treated in hospitals or delayed care, Giza said. It is unclear when patient volumes will rebound, she said.

Fresenius implemented a new operating model in 2023, replacing its regional management system with a more centralized structure. The company will look to expand its value-based care programs, particularly among its chronic kidney disease patients, and provide 25% of its dialysis treatments in the U.S. in the home by 2025, Giza said.

“We have a competitive advantage in our home offering,” she said.

—Alex Kacik


12:15 CT: CVS Health looking for ‘the right asset’

CVS Health CEO Karen Lynch said the company was in the market for a primary-care asset but she steered clear of directly addressing speculation the company was exploring an acquisition of Oak Street Health.

She did not name companies viewed as potential acquisition targets. “We want to make sure it’s the right asset, at the right time and continue to evaluate options,” Lynch said. “This isn’t a one-and-done.”

Citing people familiar with the matter, Bloomberg News on Monday reported CVS was exploring an acquisition of  Chicago-based Oak Street Health that would value the primary care provider at more than $10 billion, including debt.

Much of Lynch’s presentation was an update on subsidiary Aetna’s Medicare Advantage membership enrollment. She said membership grew by low- to mid-single-digits during the annual sign-up period this year. “This result is due to a highly competitive open enrollment period,” she said.

Aetna counted 3.2 million Medicare Advantage members as of Sept. 30.

While Lynch said she was “disappointed” in the insurer’s ability to capture new Medicare Advantage members, Aetna reported strong sales among customers dually eligible for Medicare and Medicaid and from employers buying group Medicare Advantage plans for their retired workers, she said.

The enrollment miss comes as Aetna’s largest Medicare Advantage plan will lose the large quality bonuses associated with the Medicare Advantage star ratings quality program. That represents a headwind for 2024, Lynch said. “We’re going to work really hard with our distribution channels, and with our benefit designs, to mitigate that risk for individuals,” she said.

The insurer has received approval from federal regulators to diversify its main preferred provider organization contract, which will help mitigate some of the risk in 2024, Lynch said. Aetna has also focused on improving members’ experience in its Medicare Advantage plan, which will drive its ratings upward, she said.

Aetna has experienced a strong open enrollment season among customers shopping for individual coverage on the state and federal exchanges. The company expects to add more than 700,000 new individual marketplace members in 2023, bringing its total to 750,000 exchange lives. Open enrollment ends Jan. 15.

“The individual marketplace has had another year of disruption, driving members to select new plans,” Lynch said.

The company expects to close its $8 billion acquisition of Signify Health, a home health and physician enablement technology company, during the year’s first half.

—Nona Tepper


10:30 a.m. CT: FDA chief calls for better trial access, attention to misinformation

Drug developers, researchers and regulators can do better when it comes to clinical trials, Food and Drug Administration Commissioner Dr. Robert Califf said Tuesday.

That includes ensuring evidence is properly structured for definitive studies, making clinical trial processes more efficient and routinely using data from electronic health records, Califf said. “There’s often an assumption that in human clinical studies you can ignore things like missing data,” he said.

One ongoing challenge is equitable access to research trials, particularly in low-income and rural areas. It’s difficult to conduct specialty research in regions where the relevant services aren’t provided, Califf said.

“It’s asking a lot of the clinical research system to overcome structural failures of our healthcare delivery system,” Califf said. “I’m 100% in favor of doing everything we can in the clinical research system to deal with things like inequities in participation in research. But we also need to turn that focus a little bit and say, ‘What is it about our healthcare system that makes it so we start out from that perspective?'”

Califf noted the Biden administration’s efforts to bring high-speed internet to rural communities, which he said would eliminate a major reason why the researchers don’t recruit patients in those areas.

Califf also spoke of the challenges with rampant misinformation, especially online. The misinformation problem is moving in the wrong direction, and there is no clear path for how to fix it, he said. The FDA needs to be more aggressive in identifying outright lies, which he views as distinct from legitimate dissenting opinions, he said.

—Caroline Hudson


In case you missed the conference’s first day, here’s a quick rundown of the highlights:

  • Humana added at least 625,000 Medicare Advantage members during open enrollment this year, representing 13.6% year-over-year growth and far outpacing competitors, Chief Financial Officer Susan Diamond said.
  • CommonSpirit Health is making progress on its performance improvement goals, pursuing $500 million in cost savings for fiscal year 2023.
  • Oak Street Health, the Chicago-based primary-care provider for Medicare-aged patients, has big plans to open new clinics in 2023.
  • Teladoc Health’s CEO said the company is better prepared than rival telehealth providers to weather economic headwinds.
  • Centene’s exchange business is surging while its Medicare Advantage sign-ups slowed during open enrollment for 2023, CEO Sarah London said.


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Demystifying AI’s role in healthcare to reassure new providers – and old pros

A new study of more than 500 medical students, published in Academic Radiology, found students think emerging technology like AI will reduce job prospects for pathology, diagnostic radiology and anesthesiology.

Not only is this perception untrue, experts say, but it is likely to be dangerous for the global healthcare industry. There already is a severe shortage of pathologists – leading to delayed results and treatments. In fact, a JAMA Open study found in the U.S. the number of pathologists decreased by nearly 18% between 2007 and 2017.

This is why we spoke with Dr. Michael Donovan, co-founder and chief medical officer at PreciseDx, a health IT company that seeks to personalize medicine via artificial intelligence. Donovan seeks to demystify AI in healthcare.

Donovan is vice chair and professor of translational research in the department of pathology at the University of Miami. In addition to a previous academic career at Harvard Medical School and Boston Children’s Hospital, Donovan has more than 20 years of experience in the biotechnology industry, serving in various senior management roles.

Donovan earned his Bachelor of Science degree in Zoology, a Master of Science degree in Endocrinology, and a PhD in Cell and Developmental Biology from Rutgers University. He received his medical degree from the Rutgers New Jersey Medical School.

Q. A new study of medical students found they think emerging technology like AI will reduce job prospects for pathology, diagnostic radiology and anesthesiology. You say this perception is untrue. Why?

A. Emerging technologies such as AI actually present opportunities for both new and established physicians, especially in the service-driven specialties such as pathology, radiology and even anesthesiology, as they will be at the forefront of advanced medicine.

Today, the reflex response most physicians have when they hear words like ‘efficiency’ or ‘decision support tools’ and ‘machine learning’ is that a software package is going to replace what they have been trained to provide. It’s not that much different than robotics on an assembly line or the use of supply chain administrative tools that track and catalog the necessary components to build a smartphone.

So, the perception is very true; however, the reality is quite different. The introduction of AI and machine learning in radiology is probably the best example of the immediate benefits, not only for the radiologist but also the patient.

Oftentimes what is forgotten is availability of a tool that can help focus the attention of radiologists to a specific anatomic site or lesion in an image, providing a measure of accuracy that the human is not able to provide reliably and consistently, without fatigue and error.

The immediate and long-term benefits include advancing a diagnosis to drive management decisions, while also improving the diagnostic skills of the radiologist. This scenario also is true for pathology where digitization is beginning to slowly take hold of the entire field and although behind radiology, has proven advantageous on many fronts.

Machine learning image analysis devices that can highlight ‘hotspots’ in images of tissues or cytology specimens for further evaluation while also mitigating some of the risk of missing a significant process are critical when case load and volume of slides becomes insurmountable. In both settings, physicians become better diagnosticians while staying current and ahead in a field that is rapidly changing.

The role of AI and machine learning in anesthesiology is comparable but with different streams of data where the radiologist and pathologist use patient-provided parameters to understand an underlying disease, their primary focus is the image in front of them.

For the anesthesiologist, there is a more concerted assimilation of clinical and laboratory values for a defined and immediate clinical need of appropriate pain management and an uneventful surgery without complications either during or after the procedure.

The novel development of improved medications combined with the patient’s comorbidities and current physiologic state, while avoiding contraindications, requires real-time advanced data analytics, which is beyond the scope of most practitioners. Machine learning and AI in this setting is directed at ensuring patient management, and mitigating risk while in parallel advancing the skills and knowledge of the anesthesiologist.

A key point is that through these advantages and efficiencies of care provided by AI to the physician, the ultimate arbiter from a diagnostic, ethical and medical legal perspective is the physician. For example, AI alone, can’t make the final diagnosis on a radiographic scan or provide a definitive diagnosis on a patient’s image of their needle biopsy specimen.

Nor does the tool deliver the medications to the patient. The message to medical students contemplating any of these service provider professions is the following – only the physician can make these final decisions so your ‘role’ will not be replaced but rather improved and supported, with less risk while advancing your knowledge and improving your skills over time.

Q. As a digital pathology expert, why do you believe AI is a major opportunity moving forward?

A. Digital pathology has demonstrated significant advantages for creating clinical digital archives, providing a mechanism to facilitate the sign-out of cases while also creating an accessible record of any given case even if the slides and or blocks are missing. The challenge, however, is how to improve upon the initial evaluation, focusing on what is critical in any given image and promoting diagnostic accuracy while advancing the phenotypic characterization of the disease process.

Machine learning and AI are poised to assist the pathologist in their diagnostic evaluation process through digital annotation of specific regions. It also can – for some disease states such as breast and prostate cancer – phenotype and even grade cancers based on well-established histologic constructs but in a standardized and quantitative manner.

The goal of AI in digital pathology is to first assist in the diagnostic process by advancing the ‘art’ of pattern recognition and introducing concepts of standardization and quantitation into the tissue – cytologic assessment process.

Q. How can health IT leaders at provider organizations help convince caregivers to embrace AI, not fear it?

A. Health IT leaders at various provider organizations would benefit from taking time deconstructing the AI and machine learning process for the end users.

First, they must define AI and machine learning. The next step would be to outline the benefits of deploying AI and machine learning in their organizations and clinical practice, including data handling, analytics, accessibility and navigating electronic health record systems with very practical examples of day-to-day implementation.

In addition, health IT leaders must spend time reaffirming that the end goal is not to reduce headcount, but rather promote a more productive and healthier environment for all employees. There also needs to be an ongoing educational and reinforcement component that highlights stress reduction at the physician level, patient satisfaction, cost-effective care and positive health economics.

Q. Please offer some real-world examples of how AI helps caregivers do their jobs without “replacing” them.

A. In the radiology setting, there are numerous examples where AI is playing a very active role in determining a response to therapy. Recent advances – particularly in determining a response to immunotherapy – have highlighted the importance of the type of therapy and its nuanced response.

This includes not only a change in size, but of overall appearance or spatial heterogeneity of the tumor in the CT image. Once again, the radiologist is front and center in leveraging the AI- and machine learning-provided data to report on the degree of response more accurately with a particular therapeutic agent, while advancing their own knowledge to meet the demands of a field that is in flux.

The other practical real-world evidence example is in the pathology assessment of breast tumor grading where features could be used to define a grade and differentiation score for the cancer.

Currently, these assignments are based on subjectively assessed criteria that are prone to discordance both within and between pathologists. Machine learning image analysis tools have deconstructed the components of the grade and made them objective, standardized and quantitative.

Thereby, taking the ‘guesswork’ and subjectivity out of providing a grade while generating a level of diagnostic accuracy that in the near future will potentially be incorporated into the management of patients with invasive breast cancer.

Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email the writer: bs******@***ss.org
Healthcare IT News is a HIMSS Media publication.

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Zonia Motsinger

LeanTaaS acquires Hospital IQ

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LeanTaaS on Tuesday announced its acquisition of Hospital IQ. Terms of the deal were not disclosed, but the two firms say by merging they’ll create a $1 billion enterprise focused on artificial intelligence-driven operations at more than 180 U.S. health systems. 

WHY IT MATTERS

LeanTaaS provides predictive analytics to address capacity management and other operational needs for operating rooms and infusion centers in 150 health systems and 500 hospitals in 43 states. 

Hospital IQ, which has partnerships with multiple technology providers including Oracle Cerner, Altera Digital Health (formerly part of Allscripts) and Siemens Healthineers, provides workflow 

automation and workforce management.

“We’re at a crucial tipping point where health systems across the nation are struggling with the lingering effects of COVID-19 and endemic staffing challenges,” said Steve Hess, chief information officer of UCHealth, in the announcement.

UCHealth is a strategic partner and an early investor in LeanTaaS. 

“There’s certainly a market demand for these solutions, and I’m looking forward to seeing how the combined team will accelerate a new wave of AI-powered innovations to transform hospital operations,” said Hess.

LeanTaaS and Hospital IQ say they can improve performance by driving improved patient access, staff satisfaction and revenue productivity across multiple departments. 

THE LARGER TREND

Across the country hospitals are trying to figure out how to expand or optimize their spaces and processes in order to meet growing care demands. 

With AI-powered analytics and tools, healthcare systems can help streamline common workflow challenges

For example, after implementing a queue management tool for inpatient beds from LeanTaaS, UCHealth saw a 37% reduction in time to complete ICU transfers, a 4% decrease in time to admit and a 90% improved confidence in critical capacity decisions.

Analytics can help break down hospital-wide summaries for a variety of staff and providers to use. 

“Staff can quickly see, at any time and from any location, capacity status, as well as which units are performing strongly with discharges and which are falling behind and need more focused support from staff to decrease delays,” Hess told Healthcare IT News in 2021.

ON THE RECORD

“The strategic combination of LeanTaaS and Hospital IQ unites the two best companies in hospital operations at a time of profound industry need,” said Mohan Giridharadas, LeanTaaS founder and CEO, in a statement. “Every health system in the country has an urgent need to improve the utilization of both staff and assets to improve patient access.”

Andrea Fox is senior editor of Healthcare IT News.
Email: af**@***ss.org

Healthcare IT News is a HIMSS publication.

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Dion Pingree

Half of ransomware attacks have disrupted healthcare delivery, JAMA report finds

Led by University of Minnesota Public Health researchers, the Trends in Ransomware Attacks on U.S. Hospitals, Clinics and Other Health Care Delivery Organizations study quantified the frequency and characteristics of ransomware attacks on the healthcare sector from 2016 to 2021.

WHY IT MATTERS

Ransomware groups are generally aggressive on critical infrastructure like energy, healthcare and government. And the increasing frequency and severity of ransomware attacks on hospitals and healthcare organizations can disrupt operations and patient access for weeks or even months.

The risks of being hit conflate a number of issues – loss of access to critical health data, the high costs of responding to and preventing cyberattacks and threats to patient safety – that have largely shifted focus to the defense of healthcare infrastructure.

For the study, the public health researchers looked at the date of ransomware attacks, public reporting, personal health information exposure, the status of encrypted/stolen data following the attack, the type of healthcare delivery organization affected and operational disruption during an attack.

Some of the key findings are:

  • From 2016 to 2021, the annual number of ransomware attacks more than doubled from 43 to 91.
  • Almost half, or 44.4% of the cohort, disrupted the delivery of healthcare.
  • Thirty-two attacks, or 8.6% of the cohort, led to operations disruptions of more than two weeks.
  • Approximately one in five (20.6%) of healthcare organizations reported being able to restore data from backups.

Common disruptions included electronic system downtime, 41.7%, cancellations of scheduled care, 10.2%, and ambulance diversion 4.3%. 

Data exposure following an incident is a key concern for ransomware victims as hospitals and healthcare systems are required under HIPAA to protect patient data. 

The cohort incidents exposed the PHI of more patients, say researchers.

“For 59 ransomware attacks (15.8%), there was evidence that ransomware actors had made some or all of the stolen PHI public, typically by posting it on dark web forums where stolen data are advertised for sale by including a subset of records,” according to the JAMA abstract.

Researchers noted they found growing lags in reporting ransomware incidents over the study period, with one in five attacks not present in the U.S. Department of Health & Human Services Office for Civil Rights database.

As a result, “many of the statistics reported in this article are likely underestimates due to underreporting,” they said. 

The absence may be due to low PHI exposure, under guidance from HHS that states HIPAA-covered entities and their business associates do not need to report incidents if they demonstrate a low probability that PHI has been exposed.

THE LARGER TREND

The university researchers said that ransomware increasingly affected large organizations with multiple facilities during the study period. 

However, cybersecurity experts have said that more recently cybercriminals know that larger organizations are spending more on cybersecurity protections and are looking at smaller organizations with smaller budgets that are more vulnerable to their exploits.

In June 2022, Sophos found that ransomware attacks on healthcare entities doubled from 2020 to 2021 in a poll of more than 5,000 IT professionals.

“Healthcare saw the highest increase in volume of cyber attacks (69%) as well as the complexity of cyber attacks (67%) compared to the cross-sector average of 57% and 59% respectively,” the Sophos researchers said.

“In terms of the impact of these cyber attacks, healthcare was the second most affected sector (59%) compared to the global average of 53%.”

ON THE RECORD

“This cohort study of ransomware attacks documented growth in their frequency and sophistication,” the researchers said in the study report. 

“Ransomware attacks disrupt care delivery and jeopardize information integrity. Current monitoring/reporting efforts provide limited information and could be expanded to potentially yield a more complete view of how this growing form of cybercrime affects the delivery of healthcare.”

Andrea Fox is senior editor of Healthcare IT News.
Email: af**@***ss.org

Healthcare IT News is a HIMSS publication.

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Tomi Wiers