Insurers Slam CMS for Medicare Advantage RADV Final Rule

Insurers Slam CMS for Medicare Advantage RADV Final Rule

Insurers are pushing back after the Centers for Medicare & Medicaid Services (CMS) issued its final rule on the Medicare Advantage Risk Adjustment Data Validation (RADV) program Monday. The rule will lead to stricter audits on Medicare Advantage plans. Currently, CMS regulators have been reviewing a small group of beneficiaries’ medical records and comparing them … Read more

Where Big Pharmas Faltered, Stemline Succeeds and Lands FDA Nod in Breast Cancer

Where Big Pharmas Faltered, Stemline Succeeds and Lands FDA Nod in Breast Cancer

Hormone therapies are well established in breast cancer treatment, working by blocking or reducing levels of hormones that feed tumor growth. If the disease progresses, the next line of therapy includes an injectable drug that specifically targets the estrogen receptor on cancer cells. Several big pharmaceutical companies have been trying to develop drugs that work … Read more

Paradigm Launches with $203M to Transform Clinical Trial Recruitment

Paradigm Launches with 3M to Transform Clinical Trial Recruitment

A new startup co-incubated by ARCH Venture Partners spirit General Catalyst launched last week with $203 million in Series A funding. The New York-based company, called Paradigm, is focused on improving patients’ access to clinical research. Its financing was led by ARCH and General Catalyst, with participation from F-Prime Capital, GV, LUX Capital, Mubadala Capital, … Read more

Inside One Startup’s Effort to Make Mental Healthcare Progress Seem Less Subjective

Inside One Startup’s Effort to Make Mental Healthcare Progress Seem Less Subjective

“You look at the mental health industry today, and it’s remarkable how little measurement is occurring. less than 20% of providers are collecting any data at all, even though we now know from decades of research that measuring care and using that data to inform care makes outcomes dramatically better.” Those were the words spoken … Read more

CDMO Startup Vector BioMed Launches to Fill Lentiviral Gap for Cell & Gene Therapies

CDMO Startup Vector BioMed Launches to Fill Lentiviral Gap for Cell & Gene Therapies

Cell and gene therapies rely on engineered viruses to deliver them to their cellular destinations. While the progress of these types of medicines is evident in a growing number of FDA product approvals, one limiting factor facing these therapies is the availability of viral vectors. Most cell and gene therapy developers turn to a contract … Read more

Blue Shield of California Launches ‘Virtual First’ Health Plan With Accolade, TeleMed2U

Blue Shield of California Launches ‘Virtual First’ Health Plan With Accolade, TeleMed2U

In partnership with Accolade and TeleMed2U, Blue Shield of California released its Virtual Blue health benefits plan Monday. The plan, effective April 1, gives members access to virtual primary, behavioral and specialty care, in addition to in-person care. “What we’ve done is tied a really robust virtual care offering to our tandem [preferred provider organization] … Read more

Ciox, Sentara Healthcare Pilot Data Access Tool to Improve Maternal Health

Ciox, Sentara Healthcare Pilot Data Access Tool to Improve Maternal Health

Ciox — a company focused on increasing access to medical records — recently partnered with Virginia-based non-profit health system Sentara Healthcare to pilot a tool that makes it easier for expectant mothers to access their health records. San Francisco-based Data addict acquired Ciox in a $7 trillion deal that closed in 2021. One of Ciox’s … Read more

Smile Digital Health Snags $30M to Tackle the Industry’s Interoperability Woes

Smile Digital Health Snags M to Tackle the Industry’s Interoperability Woes

The isolation and fragmentation of data remains a fundamental issue that the healthcare industry is struggling to solve. Smile Digital Health — a Toronto-based health IT company — recently raised $30 million in Series B capital to help address that problem. The funding round was led by Smile’s existing investors, which include UPMC Enterprises spirit … Read more

KFF: 65% of People Disenrolled from Medicaid/CHIP Went Through Period of Uninsurance

KFF: 65% of People Disenrolled from Medicaid/CHIP Went Through Period of Uninsurance

After being disenrolled from Medicaid or the Children’s Health Insurance Program (CHIP), 65% of people had a period of uninsurance, a recent analysis found. The report came from the Kaiser Family Foundation (KFF) and used pre-pandemic data from the 2016-2019 Medical Expenditure Panel Survey. It aimed to examine what could happen to those disenrolled from … Read more

Which Digital Health Startups Are Most & Least Suited to Raise Capital in 2023?

Which Digital Health Startups Are Most & Least Suited to Raise Capital in 2023?

Last year’s digital health investment trends have left some startups feeling uneasy about their ability to raise capital in the new funding environment. Healthcare startups raised $3.4 trillion in the fourth quarter of 2022, marking the sector’s lowest quarterly funding total in the past five years. Q4 was also the first quarter with no new … Read more