WATCH LIVE: Medicaid Services Administrator Mehmet Oz holds press conference
All times eastern The Evening Edit with Elizabeth Macdonald FOX News Radio Live Channel Coverage WATCH LIVE: Medicaid Services Administrator Mehmet Oz holds press conference
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CBS News
an hour ago
- CBS News
Newton pediatrician accused of unwanted touching from patient family members
The Massachusetts Board of Registration in Medicine has suspended the medical license of a Newton pediatrician who is accused of having unwanted physical contact with the female family members of patients. Dr. Benjamin faces indecent assault charge The disciplinary action against Dr. Jonathan A. Benjamin was decided at the board's June 13 meeting. "The Board alleges that Dr. Benjamin engaged in boundary violations," stated a press release after the meeting. Benjamin was given seven days to appeal the decision. Details of the allegations against Benjamin are few. According to records held by Newton District Court, Benjamin is charged with indecent assault and battery on a person over 14. His arraignment is scheduled for July 7. Benjamin has been licensed to practice in the Commonwealth since 1981 and owns his own practice in Newton, according to the board. Patient guardians release statement A guardian of Benjamin's patients, who wished to remain anonymous, released a statement in defense of the doctor. "I have two children, and our family has been cared for by Dr. Benjamin for five years. He has hugged me, held my hands, and kissed me on the cheek many times at appointments - sometimes in front of my husband. He has treated me like family since the first time I walked into his office with my baby. I completely understand how his physical behavior toward the mothers of his patients may make some women feel uncomfortable, but I truly believe his actions are that of a misguided older doctor, and not at all coming from a place of sexual harassment or assault. The courts will consider intent alongside impact, and the public should do the same and not jump to conclusions based on what they read on social media," the person wrote. A request for comment at Benjamin's practice was denied. Benjamin did not return WBZ's requests for comment.
Yahoo
an hour ago
- Yahoo
RFK Jr and Dr Oz announce insurers' ‘pledge' to reform prior authorization
The US health secretary Robert F Kennedy Jr and Dr Mehmet Oz announced a voluntary agreement with insurance companies to change prior authorization practices – where private health insurers require patients to ask for permission before they can receive medical treatment. The majority of Americans get health insurance through a private company, whether through an employer, or a privatization of public health insurance programs, such as Medicare Advantage. Prior authorization is an insurance company practice that is both common and abhorred. There are whole social media accounts devoted to egregious examples of it, campaigns for change built around it, and, in Oz's words, there is 'violence in the streets' over prior authorization – an allusion to the broad daylight killing of an insurance company CEO. Oz said repeatedly in a press conference on Monday that 85% of Americans or their loved ones had experienced a delay or denial of care thanks to prior authorization. Related: Key RFK Jr advisers stand to profit from a new federal health initiative 'The pledge is not a mandate, this is not a bill or rule – this is an opportunity for industry to show itself,' said Oz, who heads the enormous federal health insurance bureaucracy, the Centers for Medicare and Medicaid (CMS). CMS oversees the health insurance of about 68 million seniors through Medicare and about 71 million low-income and disabled Americans through Medicaid. 'It's a good start,' said Oz, 'and the response has been overwhelming.' Kennedy called the agreement 'momentous' and said it would help make the health system, 'work to make our country healthy again'. The announcement of voluntary measures echoed one made earlier in the year by Kennedy, who announced the administration had an 'understanding' with food companies to phase out synthetic dyes. Food companies later told reporters there was no agreement. Concurrently, Republicans are working to push a bill through Congress that is expected to result in at least 16 million Americans losing health insurance in the next decade. The bill would add red tape to Medicaid and, advocates say, 'punish' states that expanded care to the low-income. With Biblical references and a bullet point chart, Trump administration officials, two Republican members of Congress and even an actor who played a doctor on TV – Eric Dane of Grey's Anatomy – laid out their hopes for insurers to implement this voluntary agreement that they said covered 275 million Americans. Should they do so, insurers would work to standardize the prior authorization approval and deliver decisions faster and near real-time (not over the course of, say, weeks). Additionally, insurers would reduce the number of procedures and drugs subject to prior authorization, honor existing prior authorization approvals in the event a patient switches insurers in the course of care and build a 'public dashboard' of how the industry is doing which would allow 'medical professionals' to review every denial. Notably, insurance companies made a similar pledge to doctors, hospitals and Americans in 2018, during the first Trump administration. In a press release announcing that agreement, insurers pledged to work with doctors and hospitals to 'eliminate' prior authorization for some procedures, 'minimize care delays' and 'protect continuity of care for patients'. By 2022, the American Medical Association (AMA), which signed onto that agreement, was arguing publicly that insurers failed to live up to their end of the bargain. A 2023 survey by the AMA of 1,000 doctors found 7% of physicians had a prior authorization lead to 'a patient's disability or permanent bodily damage, congenital anomaly or birth defect or death'. Trump administration officials did acknowledge that the practice could be egregious and warranted change. 'A vaginal delivery,' often requires prior authorization, said the Trump administration Medicare director Chris Klomp, 'Why is that a question mark in this day and age?' The insurance industry often argues insurers 'target its use' to prevent wasteful testing by doctors. However, prior authorization is known to be incredibly widespread: in 2023, a spokesperson for a lobbying group told FierceHealthcare that 93% of beneficiaries were in plans that required prior authorization for nearly a quarter of services. Beneficiaries of the federal privatization program Medicare Advantage, which allows private health insurers to manage beneficiaries of the public program Medicare (and is widely regarded as more expensive for taxpayers), issued about two prior authorization requests for every one of its 32 million beneficiaries in 2023, according to the Kaiser Family Foundation. The practice has even spawned cottage industries: a ProPublica investigation found one company contracted by major insurers sold a product called 'the dial' that used an algorithm backed by artificial intelligence to control denial rates. Unlike the federal government, some states have found the nerve to legislate. In just one example, New Jersey required insurers to turn decisions around faster, required peer-to-peer conversations between doctors about the insurers' decision and required insurers to share denial rates and reasons – at least some of which one Republican congressman at the dais said he wanted, but was not in the agreement. 'I will say this being a surgeon: I'm a skeptic, the proof is going to be in the pudding,' said Dr Greg Murphy, a Republican from North Carolina, who added that he would be open to regulations, but questioned whether insurers would abide by the agreement: 'Are they doing something to placate an audience?'
Fast Company
an hour ago
- 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.
