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Small private practices and health-care providers are facing mounting financial pressures as crucial reimbursement systems remain down for the ninth day, following the cyberattack on Change Healthcare. 

Change Healthcare offers tools for payment and revenue cycle management that help facilitate transactions between providers and most major insurance companies. Its parent company UnitedHealth Group discovered that a cyber threat actor breached part of the unit’s information technology network on Feb. 21, according to a filing with the U.S. Securities and Exchange Commission. 

As a result, the company isolated and disconnected the impacted systems “immediately upon detection” of the threat, the filing said.

The fallout has caused a ripple of disruption across the U.S. health-care system. 

Doctors told CNBC the outage has left them unable to check patients’ eligibility for treatment or fill prescriptions electronically, which has created more administrative responsibility for workers that are already overwhelmed by clerical work. Perhaps more importantly, providers have been unable to receive reimbursements from insurers, effectively grinding many health systems’ revenue cycles to a halt. 

Smaller and mid-sized practices that rely on reimbursement cash flow to operate are making tough decisions about how to stay afloat. If the outage drags on for too long, experts say some practices may have to close their doors for good.

Dr. Purvi Parikh, an allergist and immunologist with a private practice in New York City, told CNBC that the breach has been a “mess” and a “big stressor.” Like many others, she said her practice hasn’t been able to receive reimbursements from insurers for patient visits, which makes it difficult for the practice to pay for operational expenses like payroll and medical supplies. 

Switching to a new platform could take weeks, Parikh said, so there’s no immediate workaround available. As of Thursday, Change Healthcare has not shared any updates about when it expects its systems to be back online.

“The most frustrating part is that nobody has any answers or solutions,” Parikh said. “We’re kind of just stuck.” 

Change Healthcare on Thursday said that ransomware group Blackcat is behind the attack. Blackcat, also called Noberus and ALPHV, steals sensitive data from institutions and threatens to publish it unless a ransom is paid, according to a December release from the U.S. Department of Justice. 

The company said it is working with law enforcement and third party consultants like Mandiant, which is owned by Google, and cybersecurity software vendor Palo Alto Networks to assess the breach.

“Patient care is our top priority and we have multiple workarounds to ensure people have access to the medications and the care they need,” Change Healthcare said in a statement to CNBC.

Dr. Kiranjit Khalsa, an allergist and immunologist who runs an independent practice in Scottsdale, Arizona, said her staff has been working longer hours to try and accommodate the extra work as a result of the breach, as well as manually calling in prescriptions.    

She said the problems around reimbursement have been the “biggest burden,” since she is worried about how she can continue to support her patients and employees. Khalsa is considering cutting back hours for staff and even closing the clinic for a few days.

“I worry about providing for them,” Khalsa told CNBC in an interview. “I also worry about: Where am I going to get this money if it does not come through? Do I need to take a loan out to keep the clinic afloat?”

Even when Change Healthcare’s systems do come back online, there are a lot of unanswered questions about what will happen next, according to Dr. Dan Inder Sraow, an interventional cardiologist who owns a private practice around Phoenix, Arizona. He said it’s not clear whether Change Healthcare will take on the responsibility of processing all the claims or if he’ll need to hire additional staff to help. 

“I don’t think that people are aware that the actual people providing the services are not able to extract revenue for those services,” Dr. Sraow told CNBC. “We don’t know how long that’s going to be, and that’s such a dangerous, dangerous thing.”

Dr. Jesse Ehrenfeld, president of the American Medical Association, said he has spent days fielding calls from concerned colleagues.

He said he spoke with one doctor who runs an oncology practice and only has up to two weeks’ worth of cash on hand. If the outage drags out, the practice won’t be able to buy the chemotherapy that its patients depend on for treatment. 

Since many providers are operating on razor-thin margins, Ehrenfeld said there is a possibility that some will go out of business. 

“We have so many practices that are on the fringe, particularly smaller practices, where they are just scraping by,” Ehrenfeld told CNBC in an interview. “Any aberration in the system where, ‘Oh, you don’t get checks for two weeks,’ obviously is a situation that does put practices at risk.”

In 2022, Change Healthcare merged with the provider Optum, which services more than 100 million patients in the U.S. and is owned by UnitedHealth, the country’s biggest health-care company by market cap.

The American Medical Association vocally opposed the merger, writing in a letter to the DOJ that the union could stifle competition, give UnitedHealth access to large data stores and potentially disrupt patient care. 

The merger ultimately went through, but the DOJ has recently launched an antitrust investigation into UnitedHealth, according to a Wall Street Journal report Tuesday.

“It’s just sort of like a perfect storm of regulatory issues [and] lack of competition — and unfortunately, the people who are really going to suffer are patients and individuals who work in the healthcare system,” said Dr. Ravi Parikh, a retina specialist that owns and operates a practice in New York City.  

The cyberattack has left Parikh’s clinic without a way to receive reimbursements for the expensive medications it administers. He said he has been thinking about contingency plans, such as seeking out cheaper medications and asking some patients to pay upfront, but his focus is on providing the best care possible. 

“The health care system could eventually come to a halt because a lot of clinics and pharmacies might not be viable,” Parikh said. 

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Meta is finally bringing ads to WhatsApp

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Meta is finally bringing ads to WhatsApp

It took 11 years since Facebook acquired it for $19 billion, but Meta is finally bringing ads to WhatsApp, marking a major change for an app whose founders shunned advertising.

Meta announced Monday that businesses will now be able to run so-called status ads on WhatsApp that prompt users to interact with the advertisers via the app’s messaging features. The ads will only be shown to users within WhatsApp’s “Updates” tab to separate the promotions from people’s personal conversations. Additionally, Meta will begin monetizing WhatsApp’s Channels feature through search ads and subscriptions. 

The debut of ads on the messaging app represents a significant step in Meta CEO Mark Zuckerberg‘s plans to make WhatsApp “the next chapter” in his company’s history, as he told CNBC’s Jim Cramer in 2022. The move to monetize WhatsApp also comes amid Meta’s high-profile antitrust case with the Federal Trade Commission over the company’s blockbuster acquisitions of the messaging app and Instagram.

Already, Meta allows advertisers to run so-called click-to-message ads on Facebook and Instagram that steer users to WhatsApp where they can directly engage with businesses. Messaging between brands and consumers “should be the next pillar of our business,” Zuckerberg told analysts in April, adding that WhatsApp now has over 3 billion monthly users, including “more than 100 million people in the U.S. and growing quickly there.”

Now, companies can run those kinds of ads within WhatsApp itself. The new status ads appear in a user’s Updates tab within that tab’s “Status” feature that can be used to share pictures, videos and text that vanish after 24 hours, akin to Instagram Stories. 

Since Meta bought WhatsApp in 2014, the popular messaging app has continued to grow worldwide. But unlike Facebook, Instagram and most recently Threads, WhatsApp has never allowed advertising.

WhatsApp’s co-founders, Jan Koum and Brian Acton, were public in their scorn for the advertising industry, and the duo left Facebook after reportedly clashing with executives who were eager to inject the app with advertising and other practices they shunned.

The social media company does not reveal WhatsApp’s specific sales, but analysts have previously estimated the app’s revenue to be between $500 million and $1 billion from charging businesses for tools and services so they can message customers on the app.

Meta will “use very basic information” to recommend which ads to show WhatsApp users, Nikila Srinivasan, Meta’s head of product for business messaging, said Friday. This includes a person’s country, city, device, language and data like who they follow or how they interact with ads. 

The company debuted WhatsApp’s Updates tab in June 2023 along with an accompanying Channels feature that allows people and organizations to send broadcast messages and updates to their followers as opposed to personal conversations. Meta will also monetize the Channels feature, the company said Monday.

Organizations and people who are Channel administrators will now be able to spend money to boost the visibility of their respective Channels when a person searches for them via a directory, similar to ads on Apple’s and Google’s app stores.

Additionally, channel administrators will be able to charge users monthly subscription fees to access exclusive updates and content, Meta said Monday. The company will not immediately make money from those monthly subscription fees, but it plans to eventually take a 10% cut of those subscriptions, a spokesperson said.

Meta hopes that by limiting its new ads to WhatsApp’s Updates tab it will disrupt users as little as possible, Srinivasan said. Users’ status updates as well as personal messages and calls on WhatsApp will remain encrypted, she said.

“We really believe that the Updates tab is the right place for these new features,” Srinivasan said.

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Taiwan blacklists China’s Huawei and SMIC, further aligning with U.S. trade policy

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Taiwan blacklists China's Huawei and SMIC, further aligning with U.S. trade policy

The U.S. has placed major chip export restrictions on Huawei and Chinese firms over the past few years. This has cut off companies’ access to critical semiconductors.

Jaap Arriens | Nurphoto | Getty Images

Taiwan has added China’s Huawei and SMIC to its trade blacklist in a move that further aligns it with U.S. trade policy and comes amid growing tensions with Beijing. 

The two leading Chinese chip firms have been put on Taiwan’s “Strategic High-Tech Commodities Entity List,” along with many of their international subsidiaries.

Taiwan’s current regulations require licenses from regulators before domestic firms can ship products to parties named on the entity list. 

In a statement on its website, Taiwan’s International Trade Administration said that Huawei and SMIC were among the 601 new foreign entities, blacklisted due to their involvement in arms proliferation activities and other national security concerns.

Huawei and SMIC are also on a U.S. trade blacklist and have been impacted by Washington’s sweeping controls on advanced chips. Companies such as contract chipmaker Taiwan Semiconductor Manufacturing Co already follow U.S. export restrictions. 

However, the addition of Huawei and SMIC to the Taiwan blacklist is likely aimed at the reinforcement of this policy and a tightening of existing loopholes, Ray Wang, an independent semiconductor and tech analyst, told CNBC. 

He added that the new domestic export controls could also raise the punishment for any potential breaches in the future. 

UBS GWM: Taiwan's security means it needs to remain relevant to the world, including China

TSMC had been embroiled in controversy in October last year when semiconductor research firm TechInsights found a TSMC-made chip in a Huawei AI training card. 

Following the discovery, the U.S. Commerce Department ordered TSMC to halt Chinese clients’ access to chips used for AI services, according to a report from Reuters. TSMC could also reportedly face a $1 billion as penalty to settle a U.S. investigation into the matter.

Huawei has been working to create viable alternatives to Nvidia‘s general processing units used for AI. But, experts say the company’s advancement has been limited by export controls and a lack of scale and capabilities in the domestic chip ecosystem. 

Still, Huawei is believed to have acquired several million GPU dies from TSMC for its AI chips by using previous loopholes before they were discovered, according to Paul Triolo, partner and senior vice president for China at advisory firm DGA-Albright Stonebridge Group. 

A die refers to a small piece of silicon material that serves as the foundation for building processors and contains the intricate circuitry and components necessary to perform computations. 

The Taiwanese government’s crackdown on exports to SMIC and Huawei also comes amid tense geopolitical tensions with Mainland China, which regards the democratically governed island as its own territory to be reunited by force, if necessary.

In April, the U.S. reaffirmed its commitment to support the existing status quo as China conducted large-scale military exercises off the coast of the island.

In statements reported by state media on Sunday, China’s top political adviser Wang Huning echoed Beijing’s position, calling for the promotion of national reunification with Taiwan and for resolute opposition to Taiwan independence. 

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AI is disrupting the advertising business in a big way — industry leaders explain how

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AI is disrupting the advertising business in a big way — industry leaders explain how

An AI assistant on display at Mobile World Congress 2024 in Barcelona.

Angel Garcia | Bloomberg | Getty Images

Artificial intelligence is shaking up the advertising business and “unnerving” investors, one industry leader told CNBC.

“I think this AI disruption … unnerving investors in every industry, and it’s totally disrupting our business,” Mark Read, the outgoing CEO of British advertising group WPP, told CNBC’s Karen Tso on Tuesday.

The advertising market is under threat from emerging generative AI tools that can be used to materialize pieces of content at rapid pace. The past couple of years has seen the rise of a number of AI image generators, including OpenAI’s DALL-E, Google’s Veo and Midjourney.

In his first interview since announcing he would step down as WPP boss, Read said that AI is “going to totally revolutionize our business.”

“AI is going to make all the world’s expertise available to everybody at extremely low cost,” he said at London Tech Week. “The best lawyer, the best psychologist, the best radiologist, the best accountant, and indeed, the best advertising creatives and marketing people often will be an AI, you know, will be driven by AI.”

Read said that 50,000 WPP employees now use WPP Open, the company’s own AI-powered marketing platform.

“That, I think, is my legacy in many ways,” he added.

Outgoing WPP CEO says AI will 'revolutionize' advertising business

Structural pressure on creative parts of the ad business are driving industry consolidation, Read also noted, adding that companies would need to “embrace” the way in which AI would impact everything from creating briefs and media plans to optimizing campaigns.

A report from Forrester released in June last year showed that more than 60% of U.S. ad agencies are already making use of generative AI, with a further 31% saying they’re exploring use cases for the technology.

‘Huge transformation’

Read is not alone in this view. Advertising is undergoing a “huge transformation” due to the disruptive effects of AI, French advertising giant Publicis Groupe’s CEO Maurice Levy told CNBC at the Viva Tech conference in Paris.

He noted that AI image and video generation tools are speeding up content production drastically, while automated messaging systems can now achieve “personalization at scale like never before.”

Read more CNBC tech news

However, the Publicis chief stressed that AI should only be considered a tool that people can use to augment their lives.

“We should not believe that AI is more than a tool,” he added.

And while AI is likely to impact some jobs, Levy ultimately thinks it will create more roles than it destroys.

“Will AI replace me, and will AI kill some jobs? I think that AI, yes, will destroy some jobs,” Levy conceded. However, he added that, “more importantly, AI will transform jobs and will create more jobs. So the net balance will be probably positive.”

This, he says, would be in keeping with the labor impacts of previous technological inventions like the internet and smartphones.

AI is moving from curiosity to action, Publicis' Maurice Levy says

“There will be more autonomous work,” Levy added.

Still, Nicole Denman Greene, analyst at Gartner, warns brands should be wary of causing a negative reaction from consumers who are skeptical of AI’s impact on human creativity.

According to a Gartner survey from September, 82% of consumers said firms using generative AI should prioritize preserving human jobs, even if it means lower profits.

“Pivot from what AI can do to what it should do in advertising,” Greene told CNBC.

“What it should do is help create groundbreaking insights, unique execution to reach diverse and niche audiences, push boundaries on what ‘marketing’ is and deliver more brand differentiated, helpful and relevant personalized experiences, including deliver on the promise of hyper-personalization.”

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