Latest news with #HealthPlan
Western Telegraph
14-05-2025
- Health
- Western Telegraph
Expand volunteer programme to bolster NHS workforce, charity says
The move could help with staffing problems in the health service as well as slashing the cost of relying on agencies that supply temporary staff, experts said. The Volunteer to Career programme has been piloted by the charity Helpforce in 48 NHS organisations across England. It provides training, mentorship and support to help volunteers transition to professional roles. Helpforce is now urging the Government to consider the scheme as part of its upcoming 10 Year Health Plan, claiming it could help fill around 23,600 frontline vacancies and related study placements by the end of the current Parliament in 2029. We urge the Government to consider Volunteer to Career expansion within its upcoming NHS 10-Year Health Plan, unleashing the potential of home-grown healthcare talent Amerjit Chohan, chief executive of Helpforce According to the charity, around 107,000 NHS secondary care roles in England are vacant and the annual cost of using agency and bank staff has topped £10 billion. Amerjit Chohan, chief executive of Helpforce, said: 'The success of the Volunteer to Career programme to date has been significant. 'Together with our partners in NHS trusts and other organisations, we've helped people who are interested in healthcare careers but don't have a background in the field to gain valuable experience before applying for paid roles. 'Through expertly designed and structured pathways, volunteers can find their niche without the immediate pressure of employment, while being upskilled and given confidence to take into job interviews. 'Since we launched the pilot initiative in 2022, hundreds of people have taken part, with 55% of them successfully transitioning from volunteering roles to paid careers in healthcare or associated courses – such as in nursing and midwifery. 'Our analysis shows that with the right investment, there's clear potential to supersize the opportunity, with conservative capacity for each of the 215 NHS trusts in England to support an average of 50 volunteers annually. 'We urge the Government to consider Volunteer to Career expansion within its upcoming NHS 10-Year Health Plan, unleashing the potential of home-grown healthcare talent.' It comes after Prime Minister Sir Keir Starmer set out a number of measures to help bring down immigration on Monday. The White Paper includes plans to end care worker visas for overseas recruitment. Think tanks the King's Fund and the Health Foundation have backed Helpforce's call to the Government. Dr Jennifer Dixon, Health Foundation chief executive, said the results of the pilot have been 'significant' and scaling it up ' has to be worthy of serious consideration by a government that's eager to get people back to work'. Sarah Woolnough, chief executive of the King's Fund, added: 'At a time when the NHS is severely stretched and tackling long-standing and chronic workforce shortages, Helpforce is doing excellent, innovative work to support volunteers to explore opportunities for an NHS career. 'To implement Volunteer to Career on a mass scale would require strategic investment in volunteer managers across NHS Trusts, but such investment would likely be cost-effective when set against paying high fees to agencies that supply temporary staff and helping to reduce the health services' reliance on recruiting large numbers of healthcare staff from overseas.'
CBS News
01-05-2025
- Health
- CBS News
1.8 million Texans could lose current health insurance provider if state lawmakers don't act
More than 125,000 North Texas families could soon lose their current health insurance provider if state lawmakers don't act. In March 2024, the Texas Health and Human Services Commission announced plans to drop the Cook Children's nonprofit Health Plan, along with Texas Children's and Driscoll Children's plans, and award Medicaid contracts to several national, for-profit insurance companies instead. CBS News Texas "Why would the state take contracts away from Texas-based companies and give them to national companies, where those profits and earnings are going to go outside the state of Texas?" said Karen Love, president of the Cook Children's Health Plan. "We need to keep those here in the state of Texas so that people like us can continue to make investments in the health of our community." Cook Children's is working with state lawmakers on bills that would reinstate the children's hospital plans across the state and make changes to the process moving forward. However, the clock is ticking with just four weeks left in this legislative session. "The legislature has made their will known in the past," Love said. "They just need to make their will known in this case." If lawmakers don't act, Cook Children's says 1.8 million children and pregnant women across Texas would be forced to change health insurance plans. That includes 125,000 North Texas children who are currently on the Cook Children's Health Plan. "I feel like removing this plan punishes families who already have to navigate a life that's hard," said Liz Pinon, whose children are on the Cook Children's Health Plan. "My kids would probably be okay, but there's so many kids out there that will not be okay. So many families that will get hurt for this." Pinon's triplets have been patients at Cook Children's Medical Center since they were babies, and all have complex medical needs. "My daughter is in a wheelchair," Pinon said. "My son has a feeding tube. They have mental health issues." She says juggling all their appointments and care has been easier since moving to the Cook Children's Health Plan about seven years ago. The pediatric healthcare system has managed Medicaid coverage for medically fragile children, low-income families, and pregnant women for more than 20 years. "The Cook Children's Health Plan has given us the tools so that my kids are not just surviving, they're thriving and living a healthy life," said Pinon. In the final weeks of the legislative session, she hopes lawmakers think about her family and the thousands of others who would be left scrambling if the Medicaid contracts go to out-of-state, for-profit corporations. "These are families who may be working two to three jobs to cover the rent and groceries and, you know, childcare and all of those things," Love said. "To have to worry about finding and picking a different plan, getting to know a new service coordinator, potentially having to change providers… That's just a level of disruption that's not necessary for these families when they have made their choice clear." If state lawmakers don't pass a legislative solution to address this, Cook Children's will continue its legal battle against the Texas Health and Human Services Commission. The hospital won a temporary injunction against the agency last fall. A trial has been set for November.
Business Wire
28-04-2025
- Health
- Business Wire
Curant Health Launches PlanPlus™, A Specialized Division Dedicated to Health Plan Member Solutions And Business Intelligence
ATLANTA--(BUSINESS WIRE)--Curant Health, a multifaceted Medication Care Management ® organization dedicated to the care of complex patients nationwide, is proud to announce the launch of its PlanPlus ™ business unit. PlanPlus ™ is solely focused on improving the clinical health outcomes of Health Plan member populations via award-winning complex care patient services, and unmatched business intelligence capabilities. Curant Health is URAC, ACHC, NABP and HITRUST certified with 12 IRB clinical studies, validating significant improvements in operational, clinical, financial, and patient-reported outcomes. 'Curant Health developed PlanPlus™ to be a focused business unit providing best-in-class member solutions to our Health Plan partners looking to improve their Medicare Advantage Stars Ratings, HEDIS Scores and expand their Business Intelligence" Share 'Curant Health developed PlanPlus™ to be a focused business unit providing best-in-class member solutions to our Health Plan partners looking to improve their Medicare Advantage Stars Ratings, HEDIS Scores and expand their Business Intelligence and data services. PlanPlus ™ is the culmination of 25 years of improving the lives of patients with complex care needs. This experience makes PlanPlus ™ uniquely qualified to support members around the country and impact Medicare Stars performance and Total Cost of Care in a continuously evolving Health Plan landscape,' said Patrick Dunham, CEO and Co-Founder of Curant Health. Curant Health's PlanPlus ™ business unit further highlights its commitment to life-saving patient support and the empowerment of Health Plans looking to improve the clinical outcomes of their members. For more information, please visit About Curant Health Curant Health is a proven adherence organization that specializes in clinician empowered & tech-enabled medication adherence and utilization management support to maximize Medicare program Stars performance and minimize commercial plan Total Cost of Care (TCoC). Curant Health's solutions for Health Plans include products focused on Stars Adherence Improvement, HEDIS Gap Closure, Medication Reconciliation Post-Discharge, High Cost & Complex Care Monitoring, and Total Cost of Care Reduction. Curant Health leverages member risk stratification/segmentation and enhanced member engagement services to deliver optimal member and partner outcomes while providing real-time insights and program strategy through dynamic business reviews. For more information, please visit
Mid East Info
22-04-2025
- Business
- Mid East Info
Kiteworks Releases 2024 Top 11 Data Breaches Report Using Risk Exposure Index to Reveal True Breach Impact - Middle East Business News and Information
Proprietary Risk Scoring Shows Data Sensitivity Outweighs Record Count in Breach Severity—National Public Data Breach Tops Risk Score at 8.93, While Change Healthcare's Supply Chain Impact Scores Perfect 10.0 Kiteworks, which empowers organisations to effectively manage risk in every send, share, receive, and save of sensitive data, today releases its 'Top 11 Data Breaches of 2024' report. The research applies Kiteworks' Risk Exposure Index (REI), a proprietary methodology introduced in summer 2024, to quantify and compare the severity of the year's most significant breach events. The REI assessment reveals that raw numbers of records exposed, while important, tell only part of the story. By analysing factors including data sensitivity, financial impact, regulatory implications, and attack sophistication, the report provides a nuanced measurement of organizational and consumer risk far beyond traditional metrics. 'Our Risk Exposure Index assessment of these breaches demonstrates what traditional reporting often misses,' says Tim Freestone, Chief Marketing Officer at Kiteworks. 'When we look beyond headline figures, we see that data sensitivity outranks all other factors in determining breach severity, confirming that what was stolen matters more than how much was taken. This insight enables organisations to more effectively prioritize their security investments.' Key Risk Exposure Index Findings Supply Chain Impact Reaches Perfect Score: The Change Healthcare breach received a 10.0 Supply Chain Impact score, the highest possible rating, reflecting the catastrophic downstream effects on thousands of healthcare providers nationwide. By comparison, the National Public Data breach scored 8.5 for Supply Chain Impact, illustrating how our methodology quantifies ecosystem-wide risk. Attack Vector Sophistication Varies Significantly: The report's analysis shows significant variation in Attack Vector Sophistication scores, ranging from 5.4 (DemandScience) to 8.4 (National Public Data). This variance highlights how some breaches exploit advanced persistent techniques while others leverage basic misconfigurations. Risk Score Rankings Reveal True Impact: The National Public Data breach achieved the highest overall risk score (8.93) due to its unprecedented scale, while the Change Healthcare breach ranked second (8.7) despite affecting fewer records. Hot Topic (7.7), LoanDepot (7.6), and Kaiser Foundation Health Plan (7.6) demonstrate how breaches of varying sizes can pose similar risk levels when analyzed comprehensively. Data Sensitivity Drives Risk: Multi-factor analysis across all breaches indicates that the three most influential factors in determining breach severity are: Data Sensitivity (24% influence): The nature of compromised information proved the single most important factor in determining real-world impact, with financial and health data breaches creating the most significant individual harm. Financial Impact (22% influence): The economic consequences for the breached organisation and affected individuals strongly influenced overall risk assessment, with ecosystem disruption creating particularly severe impacts. Regulatory Compliance (18% influence): The regulatory environment significantly shaped breach outcomes, with highly regulated industries facing more substantial consequences and response requirements. This correlation between data sensitivity and risk score (r=0.78) was particularly strong in healthcare and financial services breaches. 'What makes our Risk Exposure Index particularly valuable is its ability to quantify factors that typically defy measurement,' says Patrick Spencer, VP of Corporate Marketing and Research at Kiteworks. 'Our multi-factor analysis reveals that data sensitivity is the single most influential factor in determining breach severity, accounting for 24% of the overall risk impact. This indicates that what was stolen matters more than how much was taken. Organisations must prioritise protecting their most sensitive data throughout its life cycle, especially in an environment where third-party risk management remains the least mature security domain in 2024, creating systematic vulnerabilities that threat actors increasingly target.' Rank Data Breach Supply Chain Impact Attack Vector Sophistication Risk Score 1 National Public Data 8.5 8.4 8.9 2 Change Healthcare 10.0 8.2 8.7 3 Ticketmaster Entertainment 6.8 8.2 8.7 4 AT&T 5.4 6.5 8.5 5 Hot Topic 8.2 7.8 7.7 6 LoanDepot 4.2 7.1 7.6 7 Kaiser Foundation Health Plan 7.8 6.9 7.6 8 DemandScience by Pure Incubation 6.9 5.4 7.1 9 Dell Technologies 5.9 7.4 7.2 10 MC2 Data 5.2 5.7 6.9 11 U.S. Environmental Protection Agency 4.2 6.8 6.2 Risk Exposure Score of Top 11 Data Breaches in 2024 The full 'Top 11 Data Breaches of 2024' report can be downloaded here.
CBS News
01-04-2025
- Health
- CBS News
Audit of UPMC finds the healthcare provider used a loophole that cost taxpayers thousands
State leaders said an audit into a UPMC health insurance program found failures to update data and delays in reporting changes led to the state overpaying thousands of dollars. The Pennsylvania Auditor General's Office announced Monday that a performance audit into UPMC's Community HealthChoices insurance program found a loophole that cost taxpayers more than $350,000. The AG's office said the audit revealed that UPMC didn't adequately perform all its required participant assessments. "UPMC either didn't perform their required assessments to see if people were still eligible for care, or when they performed the assessments, they were done too late," said Gordon Denlinger, deputy auditor general for audits. Denlinger said UPMC also didn't notify the state department of human services of eligibility status changes in a timely manner once they became aware. "This is important because DHS uses data from these assessments as a key component in determining how much UPMC gets paid to cover the care provided," he said. "We found instances where DHS paid UPMC for people enrolled in the CHC program who were deceased, went to jail, or were no longer eligible for the program," Denlinger said. He said in the 66 cases they looked at, DHS made incorrect payments for eight participants and overpaid UPMC by about $357,000 in 2022, and the state wasn't able to recover about $121,000 because of restrictions in the contract with UPMC. The Community HealthChoices program of UPMC Health Plan is designed for people who receive long-term supports through Medicare and Medicaid. It served 156,000 people in 2022. The auditors made several strong suggestions to UPMC, including to make sure DHS is informed of status changes on a weekly basis as required. "UPMC needs to make sure there is greater accountability in its management structure to make sure the required assessments are happening timely and on a regular basis," Denlinger said. "We recommend process improvements that include a monthly check of participants against the Social Security Administration's death master file to remove people who are deceased from its rolls. And we recommend contacting all participants at least once a year to make sure their status hasn't changed," he added. He said UPMC has agreed with most of their recommendations. The auditors have some advice for DHS as well. "DHS can make sure that Pennsylvanians get back all the money owed to them when they overpay for services by changing the contract languages to close this loophole, and it can update its contracts to make sure UPMC contacts all participants at least once a year to make sure their status hasn't changed," Denlinger said. A UPMC Health Plan spokesperson provided a statement to KDKA-TV that said: The spokesperson added, "While Medicaid eligibility is determined by the state, UPMC Health Plan recognizes that information obtained by Managed Care Organizations (MCOs) through interaction with participants is a vital part of the state's ability to make such determinations. As such, we continue to support a strong Medicaid program through our partnership with DHS and operate numerous program integrity efforts beyond what is discussed in the audit. This includes the work of our "Special Investigations Unit" that works to detect fraud, waste and or misuse of the Medicaid program, referring more than 2,100 potential cases to DHS or law enforcement."
