FutureFocus June 6, 2018: Pre-Claim Review Demo Re-Start - What You Need to Know

Lisa Remington

News permeated the industry as notice of the pre-claim review demonstration is restarting and expanding. The demonstration will impact 1.3 million claims each year. Of interest to our readers is the report issued by the congressional watchdog agency, the General Accounting Office (GAO). CMS wants to identify new opportunities for expanding prior authorizations for additional items and services with high unnecessary utilization and high improper payment rates. The CMS asked for public input on how it can ensure the new experiment doesn't harm access to care. Comments are due July 31.

Lisa Remington, President, Remington Health Strategy Group

by: The Remington Report

In this week's trending news, we read about a new CEO appointment and the acquisition of an IT company.

The Visiting Nurse Association of the Treasure Coast Names New CEO

The VNA of the Treasure Coast located in Vero Florida has named Lundy Fields as its new president and CEO. Lundy, who joined the VNA’s board of directors last August, brings with him a wealth of experience, working with large healthcare companies including Johns Hopkins and Cleveland Clinic.

“I am greatly humbled to serve as VNA’s CEO and am excited about the journey ahead,” exclaimed VNA’s President and CEO, Lundy Fields. “With three key attributes: honesty, trust and integrity, at the core of VNA’s values, we will continue to fulfill our mission of setting the standard for patients and caregivers needing home health, hospice and community health services.”

ResMed Acquires HEALTHCAREfirst

ResMed (NYSE:RMD, ASX:RMD), a global leader in connected healthcare solutions, announced it has entered into a definitive agreement to acquire privately held HEALTHCAREfirst, a provider of software solutions and services for home health and hospice agencies.

HEALTHCAREfirst offers electronic health record (EHR) software, billing and coding services, and advanced analytics that enable home health and hospice agencies to optimize their clinical, financial and administrative processes. HEALTHCAREfirst will complement ResMed’s existing software solutions offered by Brightree, a wholly owned subsidiary ranked as one of the top 100 healthcare IT companies in the United States.

The transaction’s financial terms were not disclosed, but the transaction will not be material to ResMed’s consolidated financial results. The transaction is expected to be finalized before the end of the first quarter of ResMed’s fiscal year 2019 (September 30, 2018), subject to customary closing conditions, including regulatory approvals.