Latest news with #AmericanHealthcare
Daily Mail
7 days ago
- Health
- Daily Mail
Teen Mom star Kailyn Lowry reveals why she is suffering from 'mom guilt' after son Rio's misdiagnosed lump
Kailyn Lowry is suffering from 'mom guilt' after a misdiagnosed lump on her son's belly has now resulted in potential surgery plans. On the latest episode of her podcast, Coffee Convos, the Teen Mom alum, 33, revealed she discovered what she initially believed to be 'a little hernia' on her two-year-old son Rio's torso. A doctor examined the bump last year and assured her it would 'resolve itself' - however the lump remained and has only grown worse. Rio underwent an ultrasound which determined neoplasia - a tumor - could not be ruled out. Now, a 'freaked' out Lowry is taking action to correct the issue - and is using her own experience to warn others about the importance of making health a top priority. 'He developed what I thought was like a little hernia above his bellybutton,' the mom of seven - who shares son Rio with ex-fiance Elijah Scott - began. 'And I thought it was from the ISR swim lessons because he has to roll over and float on his back, and so I thought the stress of that created this like little lump that looked like a hernia.' 'So last year I took him to the doctor and they were like, "Oh, you know, it's fine, it'll resolve itself, it's not a big deal. Send him on his way, we'll figure it out." Cool, no problem. 'This year, over the last couple weeks, I've noticed this protruding out of his abdomen,' she said. She sent her co-host a photo of the lump and noted it 'sort of looks discolored a little bit' if zoomed in. 'So, I text Elijah and I'm like, "Hey, I've got to call the pediatrician and get him in for this 'cause like at this point... it is worse than it was last year.' 'So we go to the pediatrician, and the pediatrician is like, "This is not a hernia, I'm going to get you in for ultrasound ASAP." Or I think she said stat.' 'Then the ultrasound came back and they're like, "This is definitely not a hernia,"' she added. 'To this day, right now as I'm telling you this, no one has read me the results... So on the like chart thing that I logged into, it says "Reniform nodule in the area of interest consistent with lymph node. The differential include granuloma or complex cyst. Neoplasia cannot be excluded"... And neoplasia is a tumor. So that cannot be excluded. And obviously as a mom, the first thing that my stomach sunk, and I was like, "What the f**k? What do you mean it cannot be excluded?" According to the Los Angeles Public Health Department, 'Neoplasia (nee-oh-PLAY-zhuh) is the uncontrolled, abnormal growth of cells or tissues in the body, and the abnormal growth itself is called a neoplasm (nee-oh-PLAZ-m) or tumor. It can be benign (bee-NINE) or malignant. 'Benign neoplasms do not grow aggressively, do not invade the surrounding body tissues, and do not spread throughout the body. 'Malignant neoplasms, on the other hand, tend to grow rapidly, invade the tissues around them, and spread, or metastasize (me-TAS-ta-size), to other parts of the body. 'The word 'tumor' or 'mass' is often used to describe the actual swelling or other physical appearance of a neoplasm. The word 'cancer' is often confused with neoplasia, but only malignant neoplasms are truly cancers.' The results led to Lowry seeking advice from her aunt, a pathologist, who suggested have the entire lump removed during a potential biopsy. 'And then it said, "options are clinical follow-up or tissue diagnosis." Which I think a tissue diagnosis would be a biopsy, which is fine,' she said. 'My aunt is a pathologist in Pennsylvania, I texted it to her, and she told me... "If they're going to sedate him to do a biopsy, have them just remove the whole thing." So that's what we're going to do... I actually have to call general surgery to make an appointment with them, to have them look at it. 'I say all this to say, when it comes to your health, check everything out, because I really thought it was a hernia this whole time.' 'They told me it was going to resolve itself, I didn't ask for a second opinion... And if you have access to medical treatment or care, like go check it out, because now I'm like, mom guilt, and then also just like the fact that neoplasia cannot be ruled out just freaked me out.' Lowry shared a photo of her son appearing to undergo the ultrasound to her Instagram account on Monday. The photo showed Rio sitting on his mother's lap as the technician processed the procedure.
Forbes
22-07-2025
- Health
- Forbes
Greater Price Transparency Will Improve Affordability
Price Transparency Inefficiencies plague our current healthcare system. Politicians are quick to blame these problems on the market and subsequently advocate for ever greater government control. But government programs, which are already major players in the healthcare market, provide lousy insurance for patients and undermine the viability of doctors and hospitals. Expanding the government's role will only worsen these problems. Rather than expand the government's role, reforms need to address the price opacity problem that is obstructing the ability of healthcare professionals to deliver higher quality care to patients at lower costs. The price transparency problem afflicting hospitals exemplifies the problem. As the Center for Medicine in the Public Interest (CMPI) documents, hospitals account for nearly one-third of the nation's total healthcare expenditures. While attention is often placed on pharmaceutical companies and insurance providers, hospital systems, especially nonprofit institutions, are the primary driver of healthcare cost inflation and systemic inefficiency. To substantiate this claim, CMPI documents that hospital prices have increased by more than 250% over the last 25 years, which was double the rate of overall medical care inflation. Clearly, if hospital costs are one-third of spending and those costs are rising faster than the overall healthcare sector, then hospital costs are driving healthcare inflation. But it gets even worse. Hospital costs are also growing twice as fast as the median household's income. Consequently, hospital services are becoming increasingly less affordable for the average family. And while insurers and government payers are supposed to cover these costs, a larger share is being shifted to payments through large deductibles and coinsurance obligations. Addressing the problem of price opacity will help control the growth in expenditures at hospitals because 'a significant portion of this spending arises from redundant services, excessive administrative overhead, and inefficiencies embedded in payment models.' Establishing a competitive market with clear and transparent prices would impose discipline on hospital prices, make it difficult to inflate overhead costs, and rein in expenditure growth. It is important to recognize that it matters how transparency reforms are implemented. Previous efforts to mandate transparency have fallen short due to lack of follow-through. In its Seventh Semi-Annual Hospital Transparency Report, estimated 'that only 21.1% of the 2,000 hospitals are in compliance with all of the price transparency rule requirements.' Consequently, patients and insurers still cannot easily compare prices and the ability of competition to improve quality and reduce costs is still hampered. The Trump Administration should address this problem by enforcing the existing regulations and ensuring that patients and payers have access to clear and upfront pricing data. Greater price transparency would also help mitigate the cost pressures created by the rampant abuse of the 340B program by many hospitals. The 340B program was created to subsidize hospitals and clinics serving low-income populations to help these institutions provide more care for vulnerable populations at lower cost. To achieve this goal, 340B allows qualified hospitals to buy steeply discounted drugs and then resell these medicines to Medicare or privately insured patients at full price and pocket the difference. While the program offers hospitals large profit opportunities, the costs have become a burden that inflates costs for other patients and insurers. As a New York Times investigation noted, prescription drug spending for state employees [in North Carolina] jumped almost 50 percent from 2018 to 2022. A report in May from the state treasurer's office found that 340B was partly to blame: Hospitals that participated in the program billed the state health plan far more than hospitals that did not — almost 85 percent more for certain cancer drugs. In one example, hospitals bought a drug commonly used to treat melanoma for an average of $8,000 but billed the state $21,512. Due to the extreme profitability of the program, the program has experienced rapid growth. In 2009, the discounted value of 340B purchases was $4 billion. By 2023, these purchases grew to $66 billion – a sixteen fold increase! Yet, as I document in JAMA Network, abuse of this well intentioned program has turned it into a profit center for large health systems that do not pass the savings on to patients and tend to provide less charity care than the average hospital. Worsening the impact from the program, it has grown so large that the prices for other patients are increasing to help cover 340B's costs. With over one-half of nonprofit hospitals participating in the program, not to mention major pharmacy chains, the program's adverse impacts are materially harming the broader healthcare system. Coupling price transparency reforms with policies that address the abuses by contract pharmacies and ensure that 340B hospitals serve their intended purpose can rein in the 340B program materially improve drug affordability. Markets only work when transparent prices reflect the desires of consumers and the costs of producers. While the third-party payer system creates complications, this principle holds for healthcare markets. Regulatory reforms that promote widespread price transparency offers Congress and the Trump Administration an opportunity to meaningfully bend the healthcare cost curve and improve the quality-of-care patients receive.
Medscape
30-06-2025
- Health
- Medscape
AI Eases the Peril of Transitions in Hospital Care
Artificial Intelligence (AI) has permeated nearly every sector of American healthcare in one way or another, from democratizing access to a variety of treatments by freeing up the inventory of provider time to developing cutting-edge new treatments that are sure to extend lives and deliver cures to intractable diseases. As such, one of the most tenuous passages along the medical journey for every hospital patient, the discharge process, has been among the first targets in the sights of healthcare technology teams in trying to better patient experience and outcomes while also reducing provider workloads. There's certainly no one-size-fits-all approach to implementing AI, but there is one statistic around which there's no argument: A 2023 study found that 50% of healthcare providers of all types are suffering from burnout, and similar statistics have been found in a panoply of other research. One of the factors contributing to this situation is a staffing crunch, which was highlighted in a 2024 infection-control study that found nearly 80% of the 390 hospitals in the study were understaffed. With metrics like these, freeing up the time of clinical personnel is a move toward better patient experience. Here's a look at three approaches to using AI at this important point of care. Letting AI Assistants Run the Numbers The 'capacity crisis' troubling the US health systems sparked the creation of Qventus' Inpatient Capacity Solution. First launched in 2012, and freshly updated last year, this system uses AI to predict optimal patient discharge timing as early as the first morning after admission; stage patient orders in a manner that flows toward achieving early discharge in all patients possible as evaluated on a whole-of-hospital basis; and automates discharge planning, relieving overtaxed clinical personnel of that administrative burden. 'In use at dozens of hospitals in a wide variety of categories, this system touches more than half a million patients per year,' said Jason Cohen, Qventus' chief medical officer, inpatient. 'Overall, we see that it drives up a 30% decrease in excess days, and a 10 times return on investment on average.' Jason Cohen Cohen also pointed out a 2023 French study that identified a 40% higher risk for death for older adults who had to stay in the emergency department overnight prior to being admitted to the hospital, underscoring the need to ensure beds are available, especially for the most fragile populations. A More Patient-Centered Approach to Machine Learning 'Transitions of care can be one of the most dangerous, difficult, and uncertain times in a patient's illness,' said Justin Schrager, MD, emergency physician and chief medical officer of Vital, an AI-powered patient experience company. 'You would be hard-pressed to find an experienced clinician without a healthy fear of care transitions.' Schrager noted that traditionally, most of these transitions have been extremely high touch, usually led by nurses, and focused as much on emotional support and spiritual benefits as empirical issues like medication reconciliation and parsing through discharge instructions. They tend to have a few other components in common, he said. 'Generally, almost all of them require substantial personnel to manage and avoid a tech-first approach. Additionally, most focus on post-discharge optimization rather than pre-discharge interventions,' Schrager said. 'As a technologist-physician, I see this situation as a truly great opportunity for automation that scales. But when I put on my physician-technologist hat, the key to success is personalization and utilization — something that healthcare technology has struggled with over the years.' Justin Schrager, MD Vital's discharge planning works to integrate both worlds, taking all available medical data on the patient as well as their personal information and synthesizing it into a web app. The patient receives instructions via a text message, which links them directly over to the app. Arriving there, they fill out some personal information and are then presented with their care instructions in a visually-appealing user interface and written in plain language; next steps, including any referrals needed; name, address, and phone number of the location where medications have been sent; diagnosis information, including educational videos; access to hospital records, access to the hospital's existing patient portal system; and more. 'This technology can be used to ensure that patients and their family members understand what is being provided to them and make sure that the information provided is actually valuable and personalized,' Schrager said. 'User-based design principles can be leveraged to cut (what's normally a) 10-page document down to a single page, accessible in all languages on a patient's or their family member's device, rewritten using AI to be reading-level appropriate and automatically detecting and surfacing care recommendations from the clinical team that should be present front-and-center.' Sample outcomes in one study of use of the Vital product, at Dignity Health Arizona, a large healthcare provider within the CommonSpirit Health network, included 4.4-star average patient rating across emergency department and inpatient visits and a 50% improvement in patient experience. Focusing on the Clinical Staff The hospitals of Northwell Health, headquartered in New Hyde Park, New York, the state's largest health system, had a problem in common with those served by Qventus and Vital: overburdened, overstressed providers. In focusing on discharge planning, Jill Kalman, MD, Northwell's executive vice president, chief medical officer and deputy physician-in-chief, led the system to hone in on relieving those providers of some of their administrative work, and Northwell Health, in partnership with Aegis Systems, built a platform called Ascertain. Jill Kalman, MD 'Having started in a health system, Ascertain has a unique understanding of the complexities and needs of health systems and can seamlessly integrate with and reimagine the way their existing workflows operate,' Kalman said. In addition to health systems, Ascertain also has the ability to be deployed with payers and/or independent provider groups to handle administrative tasks such as documentation, prior authorizations, and compliance. Kalman said that the platform has been generating strong results for Northwell, enabling nurses, case managers, social workers, and ancillary staff to focus more of their time on patient care rather than administrative tasks. At a time when burnout among healthcare professionals reaches almost half of all those working in the field, this is a crucial modification. 'The fact is, healthcare workers are drowning in a sea of administrative burdens…Ascertain is helping enable more streamlined clinical workflows and therefore improving turnaround times, enabling clinicians to focus less on paperwork and more on patients,' Kalman said. 'Ascertain empowers case managers by providing a single interface to manage communications with clinical teams and payers, surfacing the key medical information they need for conversations with patients and their loved ones, and automating time consuming, manual tasks such as form-filling and navigating portals, all to ensure that patients receive the right care at the right time.'
Yahoo
24-06-2025
- Business
- Yahoo
LifeMD, Inc. (NASDAQ:LFMD) Could Be Less Than A Year Away From Profitability
With the business potentially at an important milestone, we thought we'd take a closer look at LifeMD, Inc.'s () future prospects. LifeMD, Inc. operates as a direct-to-patient telehealth company that connects consumers to healthcare professionals for medical care in the United States. With the latest financial year loss of US$22m and a trailing-twelve-month loss of US$14m, the US$650m market-cap company alleviated its loss by moving closer towards its target of breakeven. Many investors are wondering about the rate at which LifeMD will turn a profit, with the big question being 'when will the company breakeven?' In this article, we will touch on the expectations for the company's growth and when analysts expect it to become profitable. This technology could replace computers: discover the 20 stocks are working to make quantum computing a reality. LifeMD is bordering on breakeven, according to the 7 American Healthcare Services analysts. They anticipate the company to incur a final loss in 2024, before generating positive profits of US$2.3m in 2025. The company is therefore projected to breakeven around 12 months from now or less. How fast will the company have to grow to reach the consensus forecasts that anticipate breakeven by 2025? Working backwards from analyst estimates, it turns out that they expect the company to grow 105% year-on-year, on average, which signals high confidence from analysts. If this rate turns out to be too aggressive, the company may become profitable much later than analysts predict. Given this is a high-level overview, we won't go into details of LifeMD's upcoming projects, though, bear in mind that by and large healthcare tech companies, depending on the stage of product development, have irregular periods of cash flow. So, a high growth rate is not out of the ordinary, particularly when a company is in a period of investment. See our latest analysis for LifeMD Before we wrap up, there's one issue worth mentioning. LifeMD currently has negative equity on its balance sheet. This can sometimes arise from accounting methods used to deal with accumulated losses from prior years, which are viewed as liabilities carried forward until it cancels out in the future. Oftentimes, losses exist only on paper but other times, it can be a red flag. There are too many aspects of LifeMD to cover in one brief article, but the key fundamentals for the company can all be found in one place – LifeMD's company page on Simply Wall St. We've also compiled a list of relevant aspects you should look at: Valuation: What is LifeMD worth today? Has the future growth potential already been factored into the price? The intrinsic value infographic in our free research report helps visualize whether LifeMD is currently mispriced by the market. Management Team: An experienced management team on the helm increases our confidence in the business – take a look at who sits on LifeMD's board and the CEO's background. Other High-Performing Stocks: Are there other stocks that provide better prospects with proven track records? Explore our free list of these great stocks here. Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email editorial-team (at) article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.
Fast Company
23-06-2025
- Business
- Fast Company
Why the big consulting firms are bad for healthcare
The healthcare industry has many ills. The payer-provider disconnect creates confusion, limits access, and exacerbates inefficiencies. Doctor and nurse burnout has led to widespread staffing shortages. This is compounded by aging infrastructure, outdated regulation, fragmented care delivery, and overly-complicated legacy systems. The list goes on. But there is a particular cancer that we could eliminate tomorrow: big consulting firms. Every year, American healthcare systems spend hundreds of millions of dollars on consulting firms that deliver PDFs instead of solutions. While patients suffer and clinicians burn out, these legacy firms collect their checks and move on—leaving implementation challenges to healthcare institutions they've diagnosed but failed to treat. Proponents of the 'Big Five' consulting model would argue that sclerotic institutions need an untainted outsider to parachute in. Someone who isn't married to the nuances of an existing system. But theorizing is easy to do when you're not tethered to the results. In healthcare, it's not just financial results the consultants are off the hook for, it's people's lives. What do providers get with a legacy consulting firm? Well, a sizable stack of documents. With massive fees to match. While a 300-page PDF may impress at first blush, it won't lead to actionable, sustainable solutions. It certainly won't allow the health system to rapidly test and refine new models of care delivery, proving which ideas do and don't work in practice. Time pressure and fitting solutions in boxes At Cactus, the design firm I cofounded, one of our clients was let go from a major health system as part of a big consulting cost-cutting round. He had been working to reduce staffing shortages and developed a novel method for care teams to work together more efficiently, freeing up precious time for overworked nurses. Despite having proven results, he was let go because the consultants couldn't fit his already-implemented, already-proven solution into their model. He has now founded a business to sell that same method to health systems as a SaaS business. Traditional consulting firms also worsen a key challenge in healthcare: time pressure. Most health systems plan year-to-year based on government reimbursements. With revenue cycles already complex, consultants often default to short-term cost cutting—an easier sell than long-term change. The result? Innovation stalls, patient experience suffers, and the cycle repeats. If it's so difficult, why not just leave healthcare alone? Because clearly, patients want better services. And by and large, those closest to the patient aren't the problem. There is an abundance of clinical excellence in the United States but this doesn't always translate to the best outcomes or patient experiences. The disconnect lies in how we approach system-level change. While working with a leading cancer center, my team found a big pain point for doctors: low compliance—in other words patients weren't following instructions. Research revealed that while treatment plans (housed in large binders) were technically sound, they weren't tailored to patients. As a result, patients would 'underperform.' We found that clearer communication, organized around actionable items and digestible content, could drive meaningful improvement. This 'user experience–first' investigation, which centered on the needs of both doctors (frustrated by low compliance) and patients (overwhelmed by information), is rarely prioritized in traditional consulting models but is core to a more modern, design-led approach. The house renovation problem Imagine you're renovating a Victorian mansion with a funky layout. The big consulting approach would be to tell the construction team to spend the allotted budget on turning the largest bedroom into two bedrooms, thereby increasing the home value. Maybe they'd advise a fresh coat of light grey paint, chosen to be least likely to offend potential buyers. But what if the person buying the home doesn't have people to fill those bedrooms? What if they would be happier with a bolder color? What if in the process of splitting the bedroom, the floorboards are found to have mold? Well, the suit-clad consultants are already gone. You're on your own, kid. Now imagine a design-led approach. In this scenario, the firm leading strategy is also the one implementing the changes. They spend the budget shifting the plumbing, dealing with mold issues as they arise. They don't add another bedroom because it's not needed, even if it would theoretically increase value. They try out a few paint swatches and see market appetite for bolder colors. Buyers are happier—they're willing to pay more! Everyone wins. From slide decks to solutions Apply this rubric to healthcare. A design-led approach can balance strategic and business goals with the realities of user experience and complexities of implementation. Consultants that also build can pilot innovations faster, see results faster, reducing overall risk and cost. This type of team can rapidly experiment and improve in a virtuous cycle like the best startups do. Design-led consulting firms that implement their own changes also have a higher stake in outcomes. They create working prototypes before prescribing final solutions. They iterate based on real-world feedback. This way mistakes are found fast and plans are adjusted before scaling, saving cost and allowing faster and more thorough implementation. A call to healthcare leaders To healthcare leaders, I ask: What could you ship in the next 90 days with a design-led approach? What might still be sitting in a binder three years from now with traditional consulting? If the answer is something that could change people's lives, and I suspect it is, it might be time to ditch the big guys. Design-led firms offer a fundamentally different relationship: partners who share your risk, commit to real-world results, and aren't afraid to get their hands dirty implementing solutions. They bring technical talent alongside strategic thinking. They work in weeks, not quarters. Most importantly, they are judged by what they build, not what they recommend. The question isn't whether you can afford this approach. The question is whether you can afford not to try it. Because while big consulting firms continue collecting their checks for delivering their slide decks, your patients and workforce are waiting for something better. They deserve it. And with the right partners, you can finally deliver it.
