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10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Requirement

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At the start of the pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA), which included a requirement that Medicaid programs keep people continuously enrolled through the end of the month in which the COVID-19 public health emergency (PHE) ends, in exchange for enhanced federal funding. Primarily due to the continuous enrollment requirement, Medicaid enrollment has grown substantially compared to before the pandemic and the uninsured rate has dropped. But, when the PHE ends, millions of people could lose coverage that could reverse recent gains in coverage. The current PHE ends October 15; however, it is expected to be extended at least until mid-January because the Biden Administration did not provide the 60-day notice they have promised indicating the PHE would end.

This brief describes 10 key points about the unwinding of the Medicaid continuous enrollment requirement, highlighting data and analyses that can inform the unwinding process as well as guidance issued by the Centers for Medicare and Medicaid Services (CMS) to help states prepare for the end of the PHE.

1. Medicaid enrollment has increased since the start of the pandemic, primarily due to the continuous enrollment requirement

Total Medicaid/CHIP enrollment grew to 89.0 million in May 2022, an increase of 17.7 million or nearly 25% from enrollment in February 2020 (Figure 1). Overall enrollment increases may reflect economic conditions related to the pandemic, the adoption of the Medicaid expansion under the Affordable Care Act in several states (NE, MO, OK), as well as the continuous enrollment requirement included in the Families First Coronavirus Response Act (FFCRA). This provision requires states to provide continuous coverage for Medicaid enrollees until the end of the month in which the public health emergency (PHE) ends in order to receive enhanced federal funding. By preventing states from disenrolling people from coverage, the continuous enrollment requirement has helped to preserve coverage during the pandemic. However, when the PHE ends, states will begin processing redeterminations and millions of people could lose coverage if they are no longer eligible or face administrative barriers during renewals even if they continue to be eligible. The continuous coverage requirement increased state spending for Medicaid, though KFF has estimated that the enhanced federal funding exceeded the higher state costs.

2. KFF estimates that between 5 million and 14 million people will lose Medicaid coverage once the PHE ends.

While the number of Medicaid enrollees who may be disenrolled during the unwinding period is highly uncertain, it is estimated that millions will lose coverage. Based on illustrative scenarios—a 5% decline in total enrollment and a 13% decline in enrollment—KFF estimates that between 5.3 million and 14.2 million people will lose Medicaid coverage during the 12-month unwinding period (Figure 2). The lower estimate accounts for factors, such as new people enrolling in the program as well as people disenrolling then re-enrolling in the program within the year, while the higher estimate reflects total disenrollment and does not account for churn or new enrollees. These projected coverage losses are consistent with, though a bit lower than, estimates from the Department of Health and Human Services (HHS) suggesting that as many as 15 million people will be disenrolled, including 6.8 million who will likely still be eligible. While the share of individuals disenrolled across states will vary due to differences in how states prioritize renewals, it is expected that the groups that experienced the most growth due to the continuous enrollment requirement—ACA expansion adults, other adults, and children—will experience the largest enrollment declines. Efforts to conduct outreach, education and provide enrollment assistance can help ensure that those who remain eligible for Medicaid are able to retain coverage and those who are no longer eligible can transition to other sources of coverage.

3. The Medicaid continuous enrollment requirement has stopped “churn” among Medicaid enrollees.

The temporary loss of Medicaid coverage in which enrollees disenroll and then re-enroll within a short period of time, often referred to as “churn,” occurs for a several reasons. Enrollees may experience short-term changes in income or circumstances that make them temporarily ineligible. Alternatively, some people who remain eligible may face barriers to maintaining coverage due to renewal processes and periodic eligibility checks. Eligible individuals are at risk for losing coverage if they do not receive or understand notices or forms requesting additional information to verify eligibility or do not respond to requests within required timeframes. Churn can result in access barriers as well as additional administrative costs. Estimates indicate that among full-benefit beneficiaries enrolled at any point in 2018, 10.3% had a gap in coverage of less than a year (Figure 3). About 4.2% were disenrolled and then re-enrolled within three months and 6.9% within six months. However, by halting disenrollment during the PHE, the continuous enrollment requirement has also halted this churning among Medicaid enrollees.

4. States are required to develop plans for how they will resume routine operations once the PHE ends.

CMS requires states to develop operational plans for how they will approach the unwinding process. These plans must describe how the state will prioritize renewals, how long the state plans to take to complete the renewals as well as the processes and strategies the state is considering or has adopted to reduce inappropriate coverage loss during the unwinding period. States must submit a report summarizing their plans by the 45th day before the end of the month in which the COVID-19 public health emergency (PHE) ends Although CMS is not requiring the plans to be approved or made publicly available, the agency is encouraging states to engage with stakeholders in developing their plans and to make the plans public.

According to a KFF survey conducted in January 2022, states were taking a variety of steps to prepare for the end of the PHE (Figure 4). Twenty-eight states indicated they had settled on plan for prioritizing renewals while 41 said they planning to take 12 months to complete all renewals (the remaining 10 states said they planned to take less than 12 months to complete renewals or they had not yet decided on a timeframe). A majority of states also indicated they were taking steps to update enrollee contact information and were planning to follow up with enrollees before terminating coverage. But the situation is evolving–as of September 2022, 23 states had posted their full plan or a summary of their plan publicly. How states approach the unwinding process will have implications for the ability of eligible individuals to retain coverage and those who are no longer eligible to transition to other coverage. Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work.

5. Maximizing streamlined renewal processes can promote continuity of coverage when the PHE ends.

Under the ACA, states must seek to complete administrative (or “ex parte”) renewals by verifying ongoing eligibility through available data sources, such as state wage databases, before sending a renewal form or requesting documentation from an enrollee. Some states suspended renewals as they implemented the MOE continuous enrollment requirement and made other COVID-related adjustments to operations. Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. However, in many states, the share of renewals completed on an ex parte basis is low. Of the 42 states processing ex parte renewals for MAGI groups (people whose eligibility is based on modified adjusted gross income), only 11 states report completing 50% or more of renewals using ex parte processes. Twenty-two states complete less than 50% of renewals on an ex parte basis, including 11 states where less than 25% of renewals are completed using ex parte processes (Figure 5). The number of states reporting they complete more than 50% of renewals using ex parte processes for non-MAGI groups (people whose eligibility is based on being over age 65 or having a disability) is even lower at 6.

As states return to routine operations when the PHE ends, there are opportunities to promote continuity of coverage among enrollees who remain eligible by increasing the share of renewals completed using ex parte processes and taking other steps to streamline renewal processes (which will also tend to increase enrollment and spending). CMS notes in recent guidance that states can increase the share of ex parte renewals they complete without having to follow up with the enrollee by expanding the data sources they use to verify ongoing eligibility. However, when states do need to follow up with enrollees to obtain additional information to confirm ongoing eligibility, they can facilitate receipt of that information by allowing enrollees to submit information by mail, in person, over the phone, and online. While nearly all states accept information by mail and in person, slightly fewer provide options for individuals to submit information over the phone (39 states) or through online accounts (41 states). A recent proposed rule, released on September 7, 2022, seeks to streamline enrollment and renewal processes in the future by applying the same rules for MAGI and non-MAGI populations, including limiting renewals to once per year, prohibiting in-person interviews and requiring the use of prepopulated renewal forms.

6. States can obtain temporary waivers to pursue strategies to support their unwinding plans.

As states prepare to complete redeterminations for all Medicaid enrollees once the PHE ends, many may face significant operational challenges related to staffing shortages and outdated systems. To reduce the administrative burden on states, CMS announced the availability of temporary waivers through Section 1902(e)(14)(A) of the Social Security Act. These waivers will be available on a time-limited basis and will enable states to facilitate the renewal process for certain enrollees with the goal minimizing procedural terminations. In guidance released on March 3, 2022, CMS outlined five targeted strategies for these waivers that include: renewing enrollee coverage based on SNAP eligibility; allowing for ex parte renewals of individuals with zero income verified within the past 12 months; allowing for renewals of individuals whose assets cannot be verified through the asset verification system (AVS); partnering with managed care organizations (MCOs) or using the National Change of Address (NCOA) database or US postal service (USPS) returned mail to update enrollee contact information; and extending the timeframe for fair hearing requests. However, it also noted that the agency would consider other renewal strategy requests that impact the state’s ability to process renewals. As of September 6, 2022, CMS had approved a total of 84 waivers for 27 states (Figure 6).

7. People who have moved since the start of the pandemic, those with limited English proficiency (LEP) and people with disabilities, may be at greater risk for losing Medicaid coverage when the PHE ends.

When the continuous enrollment requirements end and states resume redeterminations and disenrollments, certain individuals will be at increased risk of losing Medicaid coverage or experiencing a gap in coverage due to barriers completing the renewal process, even if they remain eligible for coverage. Enrollees who have moved may not receive important renewal and other notices, especially if they have not updated their contact information with the state Medicaid agency. In 2020, one in ten Medicaid enrollees moved in-state in 2020 and while shares of Medicaid enrollees moving within a state has trended downward in recent years, those trends could have changed in 2021, as more people became vaccinated against COVID-19 and the national eviction moratorium was lifted in August 2021. Additionally, people with LEP and people with disabilities are more likely to encounter challenges due to language and other barriers accessing information in needed formats. A recent analysis of state Medicaid websites found that while a majority of states translate their online application landing page or PDF application into other languages, most only provide Spanish translations (Figure 7). That same analysis revealed that a majority of states provide general information about reasonable modifications and teletypewriter (TTY) numbers on or within one click of their homepage or online application landing page (Figure 8), but fewer states provide information on how to access applications in large print or Braille or how to access American Sign Language interpreters.

CMS guidance about the PHE unwinding stresses the importance of conducting outreach to enrollees to update contact information and provides strategies for partnering with other organizations to increase the likelihood that enrollee addresses and phone numbers are up to date. CMS guidance also outlines specific steps states can take, including ensuring accessibility of forms and notices for people with LEP and people with disabilities and reviewing communications strategies to ensure accessibility of information. Ensuring accessibility of information, forms, and assistance will be key for preventing coverage losses and gaps among these individuals.

8. States can partner with MCOs, community health centers, and other trusted partners to conduct outreach.

As the end of the PHE approaches, states can collaborate with health plans and community organizations to conduct outreach to enrollees to prepare them for the end of the continuous enrollment requirement. CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment; however, states can also work with community health centers, navigators and other assister programs, and community-based organizations to provide information to enrollees and assist them with updating contact information before the PHE ends, completing the Medicaid renewal process once the PHE ends, and transitioning to other coverage if they are no longer eligible. According to a recent survey of Medicaid programs, 39 states indicated they plan to work with other state agencies and stakeholders, including 32 that plan to partner with MCOs, to assist non-MAGI Medicaid enrollees when the PHE ends. A similar survey conducted earlier in the year found that 25 states said they were planning to request MCOs to contact MAGI Medicaid enrollees to update mailing addresses.

States can take advantage of actions potential partners are already taking or planning to take to prepare for the unwinding. A survey of health centers conducted in late 2021 found that nearly 50% of responding health centers reported they have or plan to reach out to their Medicaid patients with reminders to renew their coverage and to schedule appointments to assist them with renewing coverage (Figure 9).

9. Timely data on disenrollments and other metrics will be useful for monitoring how the unwinding is proceeding.

In March, CMS announced new data requirements for states to collect and report data on eligibility and enrollment metrics prior to and during the unwinding period as well as their plans for initiating and completing renewals during the unwinding period. Specifically, CMS directs states to submit an initial baseline report that captures eligibility and enrollment data in the month prior to the end of the PHE. The baseline report consists of four data metrics—pending applications, total enrollment, estimated timeframe for completing initiated renewals, and fair hearings pending for more than 90 days (Figure 10). Once the PHE ends, states will be required to submit monthly reports that capture both cumulative and noncumulative data on application processing, renewals initiated and the outcomes of the renewals, and pending Medicaid fair hearings during the unwinding period. CMS has not committed to making these data public, potentially limiting their utility for broader monitoring; however, some states have indicated they plan to create data dashboards or make key unwinding data publicly available.

These metrics are designed to demonstrate states’ progress towards restoring timely application processing and initiating and completing renewals of eligibility for all Medicaid and CHIP enrollees and can assist with monitoring the unwinding process to identify problems as they occur. However, while the new data reporting requirements are useful, they will not provide a complete picture of how the unwinding is proceeding and whether certain groups face barriers to maintaining coverage. To fully assess the impact of the unwinding will require broader outcome measures, such as continuity of coverage across Medicaid, CHIP, Marketplace, and employer coverage, gaps in coverage over time, and increases in the number of the uninsured, data that will not be available in the short-term.

10. The number of people without health insurance could increase if people who lose Medicaid coverage are unable to transition to other coverage.

The share of people who lack health insurance coverage dropped to 8.6% in 2021, matching the historic low in 2016, largely because of increases in Medicaid coverage, and to a lesser extent, increases in Marketplace coverage. However, when states resume Medicaid disenrollments at the end of the PHE, these coverage gains could be reversed. CMS guidance provides a roadmap for states to streamline processes and implement other strategies to reduce the number of people who lose coverage even though they remain eligible. However, there will also be current enrollees who are determined to be no longer be eligible for Medicaid, but who may be eligible for ACA marketplace or other coverage. A recent MACPAC analysis examined coverage transitions for adults and children who were disenrolled from Medicaid or separate CHIP (S-CHIP) and found that very few adults or children transitioned to federal Marketplace coverage, only 21% of children transitioned from Medicaid to S-CHIP, while 47% of children transitioned from S-CHIP to Medicaid (Figure 11). These findings suggest that individuals face barriers moving from Medicaid to other coverage programs, including S-CHIP. Simplifying those transitions to reduce the barriers people face could help ensure people who are no longer eligible for Medicaid do not become uninsured. The recent proposed rule aims to smooth transitions between Medicaid and CHIP by requiring the programs to accept eligibility determinations from the other program, to develop procedures for electronically transferring account information, and to provide combined notices.

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A Look at Waiting lists for Home and Community-Based Services from 2016 to 2021

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Home and community-based services (HCBS) waivers allow states to offer a wide range of benefits and to choose—and limit—how many people receive services. The only HCBS that states are required to cover is home health, but states may choose to cover personal care and other services such as private duty nursing. Those benefits are generally available to all Medicaid enrollees who need them. States may use HCBS waivers to offer expanded personal care benefits or to provide additional services such as adult day care, supported employment, and non-medical transportation. Because waivers may only be offered to specific populations, states often provide specialized benefits through waivers that are specific to the population covered. For example, states might use an HCBS waiver to provide supported employment only to people under age 65.

States’ ability to cap the number of people enrolled in HCBS waivers can result in waiting lists when the number of people seeking services exceeds the number of waiver slots available. Waiting lists reflect the populations a state chooses to serve, the services it decides to provide, and the resources it commits. In addition, states’ waiting list management approaches differ with regard to prioritization and eligibility screening processes, making comparisons across states difficult. States are only able to use waiting lists for optional services so the number of people on waiting lists can increase when states offer a new waiver or make new services available within existing waivers; in these cases, the number of people receiving services increases, but so does the number of people on a waiting list. In many cases, people may need additional services, but the state doesn’t offer them to anyone or only offers them to people with certain types of disabilities. The unmet needs of those people would not be reflected in the waiting list numbers. Finally, although people may wait a long time to receive waiver services—45 months on average—many of the people waiting for services receive other types of HCBS while they wait.

Even though HCBS waiting lists are an imperfect measure of unmet need, there are no other measures available.  Therefore, waiting lists remain a source of concern to policymakers and proposals to eliminate them have been put forth by both Republicans and Democrats. This data note provides new information about waiting lists from KFF’s most recent survey of state Medicaid HCBS programs, highlighting why waiting lists are an incomplete measure of unmet need and why they are not comparable across states or over time.. KFF also recently provided new waiting list indicators on State Health Facts to help people better understand who is on waiting lists and what those waiting lists mean.

How did the number of states with waiting lists change between 2016 and 2021?

Between 2016 and 2021 the number of states with waiting lists has fluctuated and is currently at a low of 37 states in 2021 (out of the 50 states and DC, Figure 1). While some Affordable Care Act (ACA) opponents have cited waiver waiting lists to argue that expanding Medicaid diverts funds from seniors and people with disabilities, research shows that ACA Medicaid expansion has led to gains in coverage for people with disabilities and chronic illnesses. Waiting lists for HCBS predate the ACA Medicaid expansion, which became effective in most states in 2014, and both expansion and non-expansion states have waiting lists. Waiver enrollment caps have existed since HCBS waiver authority was added to federal Medicaid law in the early 1980s.

How did the number of people on waiting lists change between 2016 and 2021?

The number of people on waiting lists fluctuated between 2016 and 2021, from 656,000 in 2016 to 820,000 in 2018, and back to 656,000 in 2021. A contributing factor to those fluctuations—and a reason that waiting list numbers are not comparable across states—is that not all states screen for Medicaid eligibility prior to adding people to waiting lists. In 2021, most states (28) with waiting lists screened individuals for waiver eligibility among at least one waiver, but even among those states, 7 did not screen for all waivers. There were 9 states that do not screen for eligibility among any waivers and those 9 states account for over half of all people on waiting lists. Changes in total waiting lists over time may reflect changes in states’ policies towards eligibility screening (Figure 2).

In all years since 2016, over half of people on HCBS waiting lists lived in states that did not screen people on waiting lists for eligibility. One reason waiting lists provide an incomplete picture of need is that not all people on waiting lists will be eligible for services. Stakeholder interviews about HCBS waiting lists found that when waiver services are provided on a first-come, first-served basis, people enrolled in waiting lists in anticipation of future need. That study found that in some states, families would add their children to waiting lists for people with intellectual or developmental disabilities (I/DD) at a young age, assuming that by the time they reached the top of the waiting list, their children would have developed the immediate need for services. Many of those waivers offer comprehensive HCBS packages that include supported employment, supportive housing, or round-the-clock services.

When states change their eligibility screening policies, that may cause large fluctuations in waiting lists. Between 2018 and 2020, the total number of people on waiting lists decreased by 155,000 or 19%. However, that change was driven by a decrease in the number of people on waiting lists in states that did not screen for eligibility (110,000 people or 22%). The number of people on waiting lists in states that did screen for eligibility decreased by 45,000 or 14%. Nearly all the change in the national waiting list numbers between 2018 and 2020 can be explained by policy changes in two states:

  • Louisiana had nearly 30,000 people on their waiting lists for I/DD services in 2018. That year, the state implemented a new system, Screening for Urgency of Need (SUN) to determine if individuals required services soon to avoid institutionalization. Those that met the criterion of urgent or emergent need were provided with services. Those that did not remain on a registry and are screened at regular intervals or upon request, but the state does not consider the registry to be a waiting list. By 2020, the waiting list was eliminated.
  • Ohio had nearly 69,000 people on their waiting list for I/DD services in 2018. In 2019, they developed a new waiting list assessment. Using that assessment, the state was able to remove people from the waiting list who did not meet the waiver criteria and provide them with other Medicaid or state resources to meet their needs when appropriate. In 2020 and 2021, the waiting list was only about 2,000 people.

Between 2020 and 2021, waiting list enrollment declined by one percent. Overall, 19 states reported a decline in waiting list enrollment, while the remainder reported an increase (17) or no change (1).

Several states no longer operate waiting lists for certain waivers, including:

  • Minnesota and New Hampshire for people with I/DD;
  • Missouri for people with physical disabilities;
  • West Virginia and Wisconsin for seniors and people with disabilities;
  • Connecticut and Louisiana for people with mental health needs; and
  • Indiana and Kentucky for people with traumatic brain or spinal cord injuries.

A smaller number of states established new waiting lists, including:

  • Connecticut and Oregon established a waiting list for people with I/DD;
  • South Carolina established a waiting list for people with mental health needs; and
  • North Carolina established a waiting list for people with traumatic brain or spinal cord injuries.

Who is on waiting lists for HCBS?

Most people on waiting lists have I/DD, particularly in states that do not screen for waiver eligibility before placing someone on a waiting list. People with I/DD comprise 84% of waiting lists in states that do not screen for waiver eligibility, compared with 60% in states that do determine waiver eligibility before placing someone on a waiting list (Figure 3). People with I/DD comprise almost three-quarters (73%) of the total waiver waiting list population. Seniors and adults with physical disabilities account for about one-quarter (24%), while the remaining share (2%) includes children who are medically fragile or technology dependent, people with traumatic brain or spinal cord injuries, and people with mental illness. In 2021, there were no waiting lists for people with HIV/AIDS.

People who are on HCBS waiting lists are generally not representative of the Medicaid population or the population that uses HCBS. Most people on waiting lists have I/DD, but KFF analysis shows that people with I/DD comprise fewer than half of the people served through 1915(c) waivers (the largest source of Medicaid HCBS spending).

How long do people on HCBS waiting lists wait to access services and do they have access to HCBS while waiting?

In 2021, people on the waiting lists waited an average of 45 months to receive HCBS waiver services (29 of 37 states responding), up from 44 months in 2020. People with I/DD waited the longest for services, 67 months on average. The average waiting period for other waiver populations ranged from 2 months for waivers targeting seniors to 30 months for waivers that serve medically fragile children. People with I/DD residing in states that do not screen for eligibility wait longer for services than people with I/DD residing in states that do screen for waiver eligibility (81 months versus 57 months, on average). Almost all (98%) individuals currently on a waiting list are living in the community (26 of 37 states responding).

All 37 states with waiting lists prioritize certain individuals to receive waiver services when a slot becomes available. Twenty-eight states offer waivers that prioritize length of time on the waiting lists, and twenty-three states give priority to individuals in crisis/emergency status. Additionally, twenty-one states give priority to people who are moving from an institution to the community. Some states also prioritize based on risk of institutionalization (17), by degree of functional need (11), and age (3). Thirteen states report other prioritization criteria including COVID-related situations, homelessness, and instances of abuse/neglect. Most states (31 of 36 responding) use more than one priority group. Nationally, states report that over 79,000 individuals on a waiting list were offered waivers services in the past year (28 of 37 states responding).

Many people on HCBS waiting lists are receiving other HCBS while they wait. Most Medicaid benefits are provided through the state plan. States offer a variety of HCBS—such as personal care to help with bathing or preparing meals, therapies to help people regain or acquire independent living skills, and assistive technology—through their state plans. States are not allowed to use waiting lists to restrict the number of people eligible to use such services. If people on waiting lists are eligible for Medicaid HCBS, they are likely to be receiving state plan HCBS while they wait, which include home health and, in many states, personal care. They would not, however, have access to more specialized services such as supported employment or adult day care and the state plan HCBS may be more limited than what would be available through a waiver. Specifically, not all states offer personal care and among those that do, many states choose to limit services to specific sites or provider types; or to apply utilization controls on the number of hours received or costs incurred.

Of 36 states that responded to the question in 2021, all but 5 (FL, IL, IN, ND, PA) reported that individuals on a waiting list were receiving state plan HCBS. States also have other authorities to provide HCBS to people on waiting lists, including offering waiver services to children through the Early Periodic Screening, Diagnosis, and Treatment authority or using multiple, tiered waivers that provide different types and intensities of services. Medicaid enrollees can receive waiver services from one waiver while they are on a waiting list for another.

Looking ahead, shortages of direct care workers may continue to create problems for states seeking to reduce the number of people on waiting lists. States reported workforce shortages of direct care workers as the primary impact of the COVID-19 pandemic across all HCBS settings in KFF’s most recent survey of state HCBS programs. Waiting lists may reflect both shortages of workers and insufficient state funds. As the pandemic persisted, an increasing number of states reported provider closures with nearly all (44) states reporting that a provider had closed as of 2022. Although states responded to that challenge by increasing provider payment rates and increasing opportunities for people to self-direct their services, workforce challenges persist. It remains to be seen how policy changes enacted during the pandemic will affect the provision of HCBS in future years and whether the investments in HCBS through the American Rescue Plan Act will result in capacity increases even after the federal funding ends.

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RNSA22: CloudWave Acquires Sensato Cybersecurity

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RNSA22: CloudWave acquires Sensato Cybersecurity

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CloudWavethe healthcare data security expert announced today at RNSA22 that this is the case acquired Sensato cybersecuritya managed cybersecurity services company focused on protecting healthcare providers from ransomware events and other cybersecurity threats.

– The Sensato Cybersecurity Suite fits perfectly with CloudWave’s OpSus Cloud Services. The acquisition will bring together leading cloud hosting services and managed cybersecurity-as-a-service to provide hospitals and healthcare organizations with a seamless, enhanced experience.

As part of the acquisition, John Gomez, founder of Sensato and longtime healthcare information technology visionary, will join CloudWave as Chief Security and Engineering Officer. Financial details were not disclosed.

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Aestique Begins Construction On Ambulatory Surgical Center In Pennsylvania

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aestheticsa Pittsburgh-based cosmetic and reconstructive surgery provider, broke ground on a new outpatient surgical center in Greensburg, Pennsylvania.

The 14,500-square-foot outpatient facility will offer expanded services, including orthopedics and major spine surgeries.

earthman (Madison, Wisconsin) is the design office for the project, which is scheduled for completion in late 2023.

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