Oscar Health To Exit Colorado, Arkansas

The insurtech company announced that commercial and regulatory issues have pushed it to leave the two states. Changing insurance rate-setting processes in Massachusetts, higher pay for insurtech CEOS, a ransomware attack at medical tech firm Omnicell, and more are also in the news.

Modern Healthcare: Oscar Health Leaves Two States Amid Regulatory, Commercial Challenges

Oscar Health will exit Colorado and Arkansas in its push toward profitability, company executives said during its first-quarter earnings call. The insurtech does not expect the move to have a “significant or even close to material effect” on its profits for the year, Chief Financial Officer Scott Blackley said during the call. Oscar Health offered individual exchange plans in Arkansas for the first time in 2022. At the end of 2021, it counted 2,865 members in Colorado, or less than 1% of its total enrollees. (Tepper, 5/10)

The Boston Globe: State Looks To Change Health Insurance Rate Setting Process For Individuals, Small Businesses

Consumer and business advocacy groups have long decried rising health insurance premiums, warning that health care has become increasingly unaffordable. The Massachusetts Division of Insurance has responded to the cries for action with draft regulations that, advocates say, could slow the growth of premiums and increase transparency into the rate setting process for hundreds of thousands of individuals and small businesses. The regulations would reduce the number of chances insurers have to file rate increases for small businesses and require insurers to provide information to the public to support their rates for individuals and small businesses. A public session would be part of the annual review process. (Bartlett, 5/10)

Modern Healthcare: Insurtech CEOs Paid Much More Than Legacy Insurer Leaders

Bright Health Group recorded a $1.1 billion net loss in 2021. The startup’s valuation fell $10.6 billion over the course of the year. That was the greatest value loss among publicly traded health insurers in 2021. The company’s stock price dove nearly 70%. In December, the company announced a $750 million investment from rival insurer Cigna and venture capital firm New Enterprise Associates to provide a big cash infusion. Bright Health Group’s board of directors rewarded CEO Mike Mikan with a retention bonus of $7 million in restricted stock units the same month, according to a disclosure filed to the Securities and Exchange Commission. (Tepper, 5/10)

Modern Healthcare: Omnicell Discloses Ransomware Incident

Omnicell experienced a ransomware attack last week, according to forms the company filed with the Securities and Exchange Commission on Monday. Omnicell, which sells pharmacy and medication management technology to healthcare organizations, on May 4 discovered some information-technology systems had been affected by ransomware, according to an 8-K form, which companies file to notify investors and the SEC about events that could be important to shareholders. Omnicell did not respond to a request for comment on what IT systems were affected and whether they are operational. (Kim Cohen, 5/10)

Stat: Researchers Look To Deliver ‘Unbiased Judgment Of AI Bias’ In Medicine

After an explosion of excitement in the potential for machine learning in medicine, cracks in the foundation are emerging. More and more research is focusing on the ways that medical models can introduce algorithmic bias into health care. But in a new paper, machine learning researchers caution that such self-reflection is often ad hoc and incomplete. They argue that to get β€œan unbiased judgment of AI bias,” there needs to be a more routine and robust way of analyzing how well algorithms perform. Without a standardized process, researchers will only find the bias they think to look for. (Palmer, 5/11)

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San Francisco Chronicle: California Medical Board To Investigate 2-Year-Old’s Death At John Muir Medical Center

The Medical Board of California has launched an investigation into whether doctors at John Muir Health failed to properly care for a 2-year-old girl with liver cancer who died on an operating table at the organization’s Walnut Creek hospital in 2019. The inquiry comes in response to a Chronicle investigation that found John Muir leaders had dismissed warnings from staff that the community hospital was not equipped to handle such a specialized operation, known as a liver resection, on a child as young as Ailee Jong. (Gafni and Dizikes, 5/10)

Chicago Tribune: Woman Guilty Of Involuntary Manslaughter In Son’s Post-Transplant Death; ‘Jason And His Donor Heart Paid The Ultimate Price For His Parents’ Complacency’

A Park City woman was found guilty Tuesday of involuntary manslaughter for failing to provide proper care for her son, who died five years after a heart transplant gave the boy a second chance at life. Jurors in Lake County deliberated less than two hours before finding Jennifer Stroud, 41, guilty of the manslaughter charge and endangerment of a child in the death of her son, Jason, who died at the age of 11 in September 2016. The boy was born with a congenital heart defect and received a transplant at age 6, but authorities said his parents failed to keep up with important follow-up appointments, and did not maintain the critical regimen of anti-rejection drugs Jason needed to take twice daily. (Ward, 5/10)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

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