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t aided health systems early in the pandemic but physicians and others are worried that would help only hospitals not independent practices or providers anders gilberg a lobbyist with the medical group management association which represents physician practices posted on x formerly known as twitter that the government must require its contractors to extend the availability of accelerated payments to physician practices in a similar manner to which they are being offered to hospitals hhs spokesperson jeff nesbit said the administration recognizes the impact of the attack and is actively looking at their authority to help support these critical providers at this time and working with states to do the same he said medicare is pressing unitedhealth group to offer better options for interim payments to providers another idea from the federal government is to encourage providers to switch vendors away from change healthcare sisselman said he hoped to start submitting claims through a new vendor within 24 to 48 hours but it s not a practicable solution for everyone torres said suggestions from unitedhealth and regulators that providers change clearinghouses file paper claims or expedite payments are not helping it s highly unrealistic she said of the advice if you ve got their claims processing tool there s nothing you can do mary mayhew president of the florida hospital association said her members have built up sophisticated systems reliant on change healthcare switching processes could take 90 days during which they ll be without cash flow she said it s not like flipping a switch nesbit acknowledged switching clearinghouses is difficult but the first priority should be resuming full claims flow he said medicare has directed its contractors and advised insurers to ease such changes he added health care leaders including state medicaid directors have called on the biden administration to treat the change healthcare attack similarly to the pandemic a threat to the health system so severe that it demands extraordinary flexibility on the part of government insurance programs and regulators beyond the money matters critical as they are providers and others say they lack basic information about the attack unitedhealth group and the american hospital association have held calls and published releases about the incident nevertheless many still feel they re in the dark riggi of the aha wants more information from unitedhealth group he said it s reasonable for the conglomerate to keep some information closely held for example if it s not verified or to assist law enforcement but hospitals would like to know how the breach was perpetrated so they can reinforce their own defenses the sector is clamoring for more information ultimately to protect their own organizations he said rumors have proliferated it gets a little rough any given day you re going to have to pick and choose who to believe saad chaudhry an executive at maryland hospital system luminis health told kff health news do you believe these thieves do you believe the organization itself that has everything riding on their public image who have incentives to minimize this kind of thing what happens next wired magazine reported that someone paid the ransomware gang believed to be behind the attack 22 million in bitcoin if that was indeed a ransom intended to resolve some aspect of the breach it s a bonanza for hackers cybersecurity experts say some hospitals that have suffered attacks have faced ransom demands for as little as 10 000 and as much as 10 million a large payment to the change healthcare hackers could incentivize more attacks when there s gold in the hills there s a gold rush said josh corman another co founder of i am the cavalry and a former federal cybersecurity official longer term the attack intensifies questions about how the private companies that comprise the u s health system and the government that regulates them are defending against cyberthreats attacks have been common thieves and hackers often believed to be sponsored or harbored by countries like russia and north korea have knocked down systems in the united kingdom s national health service pharma giants like merck and numerous hospitals the fbi reported 249 ransomware attacks against health care and public health organizations in 2023 but corman believes the number is higher but federal efforts to protect the health system are a patchwork according to cybersecurity experts while it s not yet clear how change healthcare was hacked experts have warned a breach can occur through a phishing link in an email or more exotic pathways that means regulators need to consider hardening all kinds of products one example of the slow at best efforts to mend these defenses concerns medical devices devices with outdated software could provide a pathway for hackers to get into a hospital network or simply degrade its functioning the fda recently gained more authority to assess medical devices digital defenses and issue safety communications about them but that doesn t mean vulnerable machines will be removed from hospitals products often linger because they re expensive to take out of service or replace senator mark warner d va has previously proposed a cash for clunkers type program to pay hospitals to update the cybersecurity of their old medical devices but it was never seriously pursued warner spokesperson rachel cohen said riggi said such a program might make sense depending on how it s implemented weaknesses in the system are widespread and often don t occur to policymakers immediately even something as prosaic as a heating and air conditioning system can if connected to a hospital s internet network be hacked and allow the institution to be breached but erecting more defenses requires more people and resources which often aren t available in 2017 woods and corman assisted on an hhs report surveying the digital readiness of the health care sector as part of their research they found a slice of wealthier hospitals had the information technology staff and resources to defend their systems but the vast majority had no dedicated security staff corman calls them target rich but cyber poor the desire is there they understand the importance riggi said the issue is the resources hhs has proposed requiring minimum cyberdefenses for hospitals to participate in medicare a vital source of revenue for the entire industry but riggi says the aha won t support it we oppose unfunded mandates and oppose the use of such a harsh penalty he said kff health news is a national newsroom that produces in depth journalism about health issues and is one of the core operating programs at kff an independent source of health policy research polling and journalism learn more about kff post_title string 88 biden team unitedhealth struggle to restore paralyzed billing systems after cyberattack post_excerpt string 187 a february 21 cyberattack on change healthcare which is owned by unitedhealth is exposing vulnerabilities in the health system and shortcomings in the biden administration s response post_status string 7 publish comment_status string 6 closed ping_status string 6 closed post_password string 0 post_name string 87 biden team unitedhealth struggle to restore paralyzed billing systems after cyberattack to_ping string 0 pinged string 0 post_modified string 19 2024 03 13 11 04 23 post_modified_gmt string 19 2024 03 13 15 04 23 post_content_filtered string 0 post_parent int 0 guid string 46 https www cancertherapyadvisor com p 171207 menu_order int 0 post_type string 4 post post_mime_type string 0 comment_count string 1 0 filter string 3 raw 3 object wp_post 7457 24 id int 170704 post_author string 5 45456 post_date string 19 2024 03 08 11 00 00 post_date_gmt string 19 2024 03 08 16 00 00 post_content string 14495 equitable access to care as well as improvements in cancer diagnosis and primary prevention strategies could prevent more than 2 million cancer deaths in women each year according to a report published in the lancet 1 researchers studied premature cancer death in 2020 among women from 185 countries who had 36 cancer types 1 2 of the 2 3 million women who died prematurely an estimated 1 5 million could have avoided premature death via primary prevention or early detection strategies and the remaining 800 000 deaths could have been prevented if women had equitable access to cancer care according to researchers b eing a woman impacts timely cancer care more than being a man said lancet report author karla unger saldaña md of the national cancer institute of mexico in mexico city t here are many mechanisms behind this starting with different access to education health literacy cancer awareness and gender roles that interfere with women s ability to seek care she added women experience delays in cancer diagnosis w omen tend to be disadvantaged from first access to care for cancer even starting from diagnosis said lancet report author verna vanderpuye md of korle bu teaching hospital in accra ghana studies have suggested that several cancers tend to be diagnosed later in women than in men women tend to have longer times from first presentation to diagnosis for gastrointestinal genitourinary lung hematologic and other cancers 3 7 for example in a uk study of 18 618 patients women had delayed diagnoses of lymphoma bladder cancer colorectal cancer gastric cancer head and neck cancer and lung cancer 7 studies have also shown that women are more likely than men to first present with cancer symptoms at emergency rooms with the greatest disparities seen for lung and gastrointestinal cancers 8 9 these delays in diagnosis can mean that women are diagnosed with cancer at later stages than men research has shown that women are diagnosed with colon rectal and bladder cancer at later stages than men 10 14 delays in diagnosis may be partly explained by a lack of screening for example researchers found that health care providers are less likely to have discussions about lung cancer screening with women than with men 15 in addition although screening has been shown to reduce the incidence of cervical cancer many countries have not implemented widespread screening 16 17 how sexism impacts access to cancer care sexism has been shown to impact women s access to any type of health care and this includes cancer care 1 disrespectful or even discriminatory health care resulting from health care providers gender biases and stereotypes affects women s ability to receive the care they need dr unger saldaña noted studies have shown that women s health concerns are less likely to be taken seriously and managed appropriately than men s 18 19 women s symptoms are more likely to be perceived as psychosocial women are more likely to receive non specific diagnoses and they are more likely to be given prescriptions for psychoactive drugs a cancer specific example of overlooking women s health concerns is how physicians have delayed the diagnosis of breast cancer by inappropriately reassuring patients that a palpable mass is benign without performing a biopsy 20 research has also suggested that women with cancer are more likely than their male counterparts to experience adverse events related to cancer treatment to report inadequate pain management and to have their sexual health concerns overlooked 21 23 i n the area of breast and gynecologic cancers only very recently have people focused on sexual health and sexual side effects of cancer treatment said gita suneja md of the university of utah in salt lake city who was not involved in the lancet report these are life altering treatments that affect sexual health profoundly yet we have long neglected women s health and well being patriarchal ideas about women and women s complaints often manifest in prevalent mistreatment disrespect negligence and abuse of female patients by medical staff the authors of the lancet report wrote these types of experiences can damage patients trust in health care providers and influence the patients willingness to participate in cancer screening or seek care for cancer symptoms another potential cause of suboptimal cancer care for women is the fact that they have been underrepresented in research so cancers in women may not be as well understood as cancers in men 24 25 the causes of breast cancer for example are not well understood despite the fact that breast cancer was the most commonly diagnosed cancer worldwide in 2020 1 26 i think one of the key takeaways from our work was the degree to which sex and gender have not been adequately considered in cancer research practice and policy making said lancet report author ophira ginsburg md of the national cancer institute in bethesda maryland we underestimated the massive role that gender based and intersectional power dynamics play in the interactions of women with the cancer health system cost related barriers and intersectionality another barrier to optimal care that impacts women more often than men is the cost of care 1 research has shown that women are more likely than men to have inadequate health insurance and to forgo medical care due to costs 19 27 in one study women in latin american countries reported that health care costs prevented them from undergoing breast cancer screening 28 in another study women in uganda reported that a lack of money for medical bills and transportation was the main reason they did not seek care for symptoms of breast cancer or cervical cancer 29 women can also face barriers to care as a result of intersecting identities such as race ethnicity sexual orientation and gender identity 1 of course gender intersects with other marginalized status to further complicate things dr unger saldaña noted for example an analysis of 36 studies on access to cancer care among indigenous people in canada revealed that barriers to cervical cancer screening were related to histories of trauma and abuse including sexual and physical abuse and residential school attendance as well as the inability to locate a female health care provider 30 women belonging to sexual minority groups may also experience barriers that limit their ability to receive cancer care 1 in a us study 29 of black sexual minority women reported delays in breast cancer care of more than 3 months compared with 11 of black heterosexual women 10 of white sexual minority women and 5 of white heterosexual women 31 the role of primary prevention efforts primary prevention strategies such as avoiding tobacco and alcohol can prevent cancer deaths in women but common sex specific cancers in women are generally not amenable to primary prevention the lancet report authors noted 1 overall the proportion of cancers that are amenable to primary prevention strategies is greater for men than for women women can benefit from interventions to reduce cancer risks but these interventions must be gender appropriate according to the lancet report authors women can be...
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