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Editor’s note: Comments from the American Medical Association were added to the original article.

The patients underwent elective surgery with primary surgeons and in facilities that were in their private insurer’s network. Yet, one in five got a surprise bill after their procedure for out-of-network services, according to a new study.

The patients were left with an average potential balance of $2,011, according to the JAMA study released today.

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

See how

As politicians in Washington look at how to address the problem of surprise bills, researchers examined claims data from a large health insurer to examine how often patients unexpectedly received out-of-network bills after having in-network elective surgery. In 20% of the surgeries, patients received out-of-network charges, the study found.

Members of Congress have been grappling with ways to end surprise medical bills. The House Ways & Means Committee on Friday released largely provider-friendly legislation as a bid to end an impasse over how to handle surprise billing with a proposal to use a “mediation” process to handle disputes.

In the study, most commonly, the out-of-network bills occurred when patients received care from anesthesiologists and surgical assistants who were not part of their insurance network, which happened in 37% of the cases where patients received a surprise bill, the study found.

In cases where a surgical assistant was not in the insurance network, patients faced an average potential bill of $3,633. With out-of-network bills that resulted from the anesthesiologist being out of the patient’s network, the average potential bill was $1,219, the study found.

The analysis included almost 350,000 commercially insured patients who underwent one of seven common elective surgeries at in-network facilities with in-network primary surgeons between 2012 and 2017. Researchers said one limitation of their study was that the claims data came from only on insurer.

Patients had a greater risk of receiving an out-of-network bill when they were members of a health insurance exchange plan. Risks were also significantly higher when there were surgical complications, the study found.

In an accompanying editorial, JAMA editors said it’s time to stop surprise medical bills, which they described as “both common and potentially financially devastating.”

“Such billing practices are particularly pernicious because patients usually have no knowledge that they will occur, and no way to avoid them,” wrote Karen E. Joynt Maddox, M.D., of the Washington University School of Medicine and associate editor of JAMA, and Edward Livingston, M.D., deputy editor at JAMA.

It’s up to both clinicians and policymakers to act to end surprise billing, they said, arguing that surgeons have an ethical responsibility to speak out.

“When feasible, surgeons should ensure that all the personnel involved in the care team that they are leading accept the same insurance plans and should consider refusing to work in facilities that allow surprise billing,” they wrote.

The American Medical Association, the country’s largest physician organization, Tuesday came out in support of the bipartisan efforts of the House Ways and Means Committee to craft legislation to protect patients from surprise medical bills.

The legislation creates a two-step process for resolving disputes over reimbursement, first through a 30-day negotiation process that encourages parties to resolve their differences before using a mediation process administered by a third party.

“We support the underlying mechanism for resolving these disputes, including the eligibility of all disputed claims for negotiation and mediation. We also appreciate that the mediator must consider a wide range of supporting information submitted by physicians in rendering a final determination,” said Patrice A. Harris, M.D., AMA president, in a statement.

Harris said the AMA plans to work with the committee and others to refine the legislation so it is fair to everyone involved.

While hospitals and physicians support the legislation, payers have pushed to link out-of-network payments to a benchmark rate, rather than the arbitration process favored by providers.

Florida-based AdventHealth plans to replace its Cerner electronic health record (EHR) system with rival Epic’s.

One of the largest faith-based health systems in the country, AdventHealth operates 50 hospital campuses across a dozen states. The health system employs more than 80,000 people who serve more than 5 million patients annually and reports nearly $20 billion in annual revenue.

The health system first signed a deal with Cerner in 2002 when it was known as Adventist Health System.

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

See how

AdventHealth will begin the transition in March and will eventually roll Epic’s EHR out to 1,200 care sites. The work is expected to be completed in about three years, the health system said.

In a press release issued Tuesday, AdventHealth said it plans to install a single, integrated Epic EHR and revenue cycle management system across all of its acute care, physician practice, ambulatory, urgent care, home health and hospice facilities.

Epic’s Community Connect program will also allow AdventHealth to extend its EHR system to affiliated providers as part of the integrated platform, according to AdventHealth.

“Our journey to become a consumer-focused clinical company requires a fully connected network throughout our entire enterprise,” Terry Shaw, president and CEO for AdventHealth, said in a statement. “Connecting our network with a robust, integrated health record platform will give our caregivers access to the clinical information they need at the point of care and ultimately advance our consumer promises through a more seamless experience for those we serve.”

In an emailed statement, Cerner confirmed the changeover. “AdventHealth has made the business decision to transition over the next few years management of its EHR and revenue cycle management system to another supplier. The shift is expected to take up to five years and Cerner is committed to working closely with AdventHealth to continue delivering superior health care technology solutions throughout the transition,” the company said.

Anonymous Reddit posters predicted the change months ago, saying that the health system was frustrated with integration issues with Cerner’s ambulatory solution and revenue cycle functionalities. HIStalk first reported the Reddit posts regarding Cerner and AdventHealth.

One Reddit user said AdventHealth staff felt the health system was on the “back burner” since Cerner signed massive projects with the departments of Defense and Veterans Affairs.

It’s unclear what the loss of a big EHR client will mean for health IT company Cerner’s annual revenue or earnings.

The company continues efforts to turn its financial picture around and improve its operating performance.

Almost a year ago, activist investor Starboard Value stepped in, and Cerner reached a settlement with the hedge fund to add new directors to its board and buy back more of its shares. Cerner also agreed to take steps to improve operations and committed to hitting certain operating targets.

The new agreement between Cerner and Starboard Value, which has a 1.2% stake in the company, was seen as welcome news by many financial analysts as a plan to increase the company’s profitability.

Cerner’s full-year 2019 bookings were down 11% compared to 2018 bookings, from $6.72 billion to $5.99 billion. Company executives said during their full-year and fourth-quarter earnings call that the decline in bookings was primarily driven by the company being more selective in the types of contracts it pursues, which led to fewer large, long-term outsourcing contracts.

Congressional Democrats said they felt blindsided by the Department of Veterans Affairs’ (VA’s) decision this week to push off its go-live date for a new $16 billion medical records system.

The House Veterans’ Affairs Subcommittee on Technology Modernization plans to hold a hearing in the next few weeks to scrutinize the VA’s decision to delay the platform’s rollout, Susie Lee, D-Nevada, chairwoman of the subcommittee, announced.

The VA had planned to flip the switch on the new electronic health record (EHR) at its first site—Mann-Grandstaff VA Medical Center in Spokane, Washington—on March 28. But the VA announced this week it’s delaying plans to commence end-user training, which may impact “going live” with its EHR in March in Washington.

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

See how

“After rigorous testing of our new EHR, the department will need more time to complete the system build and ensure clinicians and other users are properly trained on it,” VA spokesperson Christina Mandreucci told FierceHealthcare in an emailed statement.

“We believe we are 75-80% complete in this regard and will be announcing a revised ‘go-live’ schedule in the coming weeks,” she said.

Lee said during a hearing on VA’s data privacy policies Wednesday that the VA needs to be “forthright about its progress, identify concerns, and notify Congress about any challenges.”

“I’ve long said that getting it right is far more important than hitting a date on a calendar. If there needs to be a delay to get the system to a place where veterans’ lives are not at risk and VA staff are ready to use it, that’s the right thing to do,” she said.

She added, “However, I’m concerned that as we have moved closer to the go-live date, we were told repeatedly there were no show-stoppers in implementation, that testing was going great, and that things were on track.”

Politico reported that the committee’s staff said the VA had not mentioned the possibility of delay in recent meetings. When the department informed Lee of the decision, VA officials employed inconsistent explanations, committee staff told Politico.

Lee acknowledged that software development and testing conditions can change rapidly, but the committee requires “transparency and for the VA to be accountable for its actions.” 

She also noted that President Donald Trump’s proposed budget would “speed up” the EHR project rollout.

The VA signed a $10 billion deal with Cerner in May 2018 to move from the VA’s customized VistA platform to an off-the-shelf EHR to align the country’s largest health system with the Department of Defense, which has already started integrating Cerner’s MHS Genesis system.

For the VA, the Cerner EHR will replace the approximately 130 operational instances of VistA currently in use across the department. While the initial EHR contract signed with Cerner was for $10 billion, the VA has pushed the estimated 10-year cost for implementing the system past $16 billion.

The VA’s delay comes a week after a key VA EHR project leader, former VA Deputy Secretary James Byrne, was abruptly dismissed. In his five months at the agency, Byrne was a key leader updating members of Congress on the progress and challenges of the implementation.

Lawmakers on both sides of the aisle want more answers on why the department pushed off its go-live date for the multibillion dollar medical records system.

Rep. Jim Banks, R-Indiana, ranking member of the committee, said during the hearing that he supported VA Secretary Robert Wilkie’s decision to delay the EHR launch but was disappointed that no VA officials in charge of the EHR project attended Wednesday’s hearing, as lawmakers had requested.

Rep. Phil Roe, M.D., R-Tennessee, the ranking member of the House Committee on Veterans’ Affairs and a member of the subcommittee, said VA’s decision to delay the project highlighted the need for lawmakers to ramp up oversight of the project.

Sen. Jon Tester, the ranking member of the Senate Veterans’ Affairs Committee, said in a statement that, “VA must establish stable leadership to provide sufficient accountability and robust oversight of this process.”

Mark Takano, D-California, chairman of the House Veterans’ Affairs Subcommittee on Technology Modernization, said he supported VA leadership taking the time they need to get the $16 billion dollar implementation right, but leaders need to be transparent with Congress.

During Wednesday’s hearing, Paul Cunningham, the VA’s deputy assistant secretary and chief information security officer, testified that he was made aware of the EHR project delay on Tuesday.

The delay was more a “tactical decision” than a result of a lack of resources, he said, while acknowledging that the project was “outside his purview.”

“Change is the only constant in life.” – Heraclitus, Greek philosopher

While the universal flux theory is 2,700 years old, in oncology, it is as applicable today as it was when the “weeping philosopher” first uttered his paradoxical doctrine.

Oncology has experienced more constant change in the last 30 years than from the late 20th century to the time cancer was first identified in 440 B.C. 

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

See how

The rapid pace of innovation in oncology has been fueled by an immense knowledge explosion about cancers, how they grow and how to treat them in different subpopulations. In fact, from May 2018 to May 2019, the U.S. Food and Drug Administration (FDA) approved almost 60 new oncology drugs.

And while the advances we see in oncology today—targeted therapies, precise diagnostics and a better patient experience—are powering a consistent drop in cancer death rates, they also require oncologists to know more than any one person possibly can.

How, then, should medical oncologists and their practices stay up to speed on advancements to ensure patient receives the right treatment at the right time?

  • Harness technology: Oncologists and their practices cannot get overwhelmed by the promise of artificial intelligence or any other aspect of technology and instead should focus on two vital deliverables: 1) an agile platform that turns data clinical, operational and financial data inputs into actionable insights; and 2) a platform for real-time peer-to-peer communication offering a virtual second opinion. Technology must work to improve physician workflow and efficiency. By engaging physicians and focusing on meeting their needs, technology and the analytical insights it reveals should help oncologists, not exacerbate physician burnout.
  • Stay flexible locally: Former House Speaker Tip O’Neill’s adage about all politics being local applies to healthcare, too. Every market in the U.S. is different, and it requires practices looking to thrive to have the flexibility to form partnerships that make sense locally. One-size-fits-all does not work for oncology practices or their patients today. Rather, practices need flexibility to form relationship with hospitals or other provider networks that make sense for their patient populations.
  • Having scale to negotiate: While flexibility is important locally, practices cannot survive without the scale to negotiate on drug purchasing, payer contracts or employer relationships. Practices don’t have to sacrifice independence for scale, but they cannot go it alone and expect to be able to offer their patients services along the continuum of care from clinical trials to palliative treatments. Practices must figure out partnerships that work so care options, most notably access to clinical trials, are expanded for patients. 
  • Embrace value: Fee-for-service care will soon be akin to skiing in jeans—a relic of the 20th century. Medicare’s voluntary—and risk free—value-based payment model in oncology will soon give way to a two-sided risk model. And while entering into two-sided risk now might not be right for every practice immediately, ignoring the tectonic shift in payment comes with peril. Practices need to understand value-based models through implementing them so their patients can benefit from better care coordination, drug utilization and communication between the care team and their patients outside the clinic. 

The practice of oncology has changed immensely since I’ve been treating patients.

My overarching advice to practices trying to negotiate the constant change that oncology offers is to not be complacent, because your patients are receiving the best care possible today. Understand where oncology is headed and how today’s trends will impact your ability to deliver care tomorrow. Do what makes the most sense for your patients and colleagues by always anticipating change rather than reacting to it.   

Jeff Patton is acting CEO and president of physician services at OneOncology. He is also a member of FierceHealthcare’s Editorial Advisory Council.

WASHINGTON, D.C.—Federal health IT leader Donald Rucker, M.D., said an upcoming interoperability rule will include “solid” privacy protections for patients as they share their medical data. 

Speaking at Health Datapalooza on Tuesday, Rucker—who is the head of the Office of the National Coordinator for Health IT (ONC)—acknowledged that privacy in a digital world is a challenging issue. But he reiterated his perspective that patients should be able to easily access and share medical data.

“It is our human right as patients to have access to our data,” he said.

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

See how

Rucker was pushing back on health IT vendor Epic’s lobbying efforts against the proposed rules, including an email Epic CEO Judy Faulkner sent to customers encouraging them to sign an opposition letter. The letter cited risks to patient privacy and intellectual property if the rules are finalized now.

According to reporting from CNBC’s Chrissy Farr, about 60 health systems signed the letter.

“Most of their customers did not sign on to that letter,” Rucker said. “If you parse out the big academic medical centers, only three out of 100 AMCs signed on.”

He also called out hospitals that signed the opposition letter due to their claims about data privacy concerns but then disregard patient privacy when filing lawsuits for unpaid medical bills.

“One of the signers of the letter is known for taking thousands of patients to court. If you take someone to court, that information becomes public discovery. Their medical care is now public. It’s part of the court record,” he said. “Looking at protecting privacy, we need to walk the walk here as we look at who is saying what and letter-writing campaigns.”

Almost a year ago, ONC issued a proposed interoperability and information-blocking rule that defines the demands on healthcare providers and electronic health record (EHR) vendors for data sharing. The rule also outlines exceptions to the prohibition against information blocking and provides standardized criteria for application programming interface (API) development. 

Department of Health and Human Services (HHS) leaders have not offered a timeline for when the rule will be published, but many have speculated it will be released during the Healthcare Information and Management Systems Society conference in March.

While Epic and many hospitals have come out against the interoperability rules, many technology vendors, including Apple and Microsoft, along with health plans and consumer advocacy groups have urged HHS to move forward with publishing the rule.

Four healthcare leaders recently penned an op-ed in Health Affairs calling for ONC to publish the rule immediately. Omada Health’s Lucia Savage and University of California, San Francisco’s Aaron Neinstein, Julie Adler-Milstein and Mark Savage said the ONC rule will not make the current consumer privacy protections worse.

“All health care stakeholders who are concerned about that issue should raise it with Congress and state legislatures, which have authority to act, rather than request to delay the ONC’s rule, delaying critical improvements to interoperability, access, innovation, and ending information blocking,” the authors wrote.

APIs are the technology used to link IT systems, such as EHRs, with apps and will help bring healthcare into the modern app economy, according to Rucker.

ONC’s vision is for patients to choose what apps to use, he said

“We’ve often looked at interoperability in a narrow view, which is just as a replacement for moving the patient’s chart. Modern computing and APIs offer a vastly richer and more empowering global computing environment. Well-built APIs can do almost anything that your creativity allows,” he said.

Before Rucker took the stage at Health Datapalooza, HHS Secretary Alex Azar also addressed the upcoming interoperability rules and the Trump administration’s commitment to putting “patients in charge of their data” and called out industry stakeholders who are “defending the status quo.” They are protecting a health records system that is “segmented and Balkanized,” he said. 

“We have a serious problem—and scare tactics are not going to stop the reforms we need,” Azar said.

For all your Friends fans out there devastated by the removal of the show from Netflix, allow us to soothe you in your time of need. Jennifer Aniston’s 2020 Golden Globes look is just the thing to lift anyone’s spirits. The actress has consistently shown up on the red carpet in gorgeous black dresses, and this year is no different. Aniston arrived to the Golden Globes in a stunning floor-length gown, and reminded us all why we’ve loved her for so long.

Jennifer Aniston effortlessly glided in front of the photographers (she’s had some practice!) wearing a beautiful black gown by Dior Haute Couture. The soft, ruffle details along the neckline and delicate belt added a bit of romance and sophistication to the entire look, making it a classic Jennifer Aniston ensemble—that is to say, a gorgeous outfit.

David Fisher/Shutterstock.

The former Friends actress gave us some major Rachel Green vibes with the sartorial excellence of this look. The addition of the sparkling Cartier diamonds around her neck and Fred Leighton earrings and rings was truly an inspired choice. (Seriously, anyone know where I, too, can get some jewels as beautiful as these? I have a date coming up, and I think it’d be really impressive.) This is truly Jennifer Aniston at her peak, and we’re so into this gorgeous (and classic) Golden Globes red carpet look.

Of course, Jennifer Aniston is not nominated for Friends, but for her new show The Morning Show on Apple TV. She’s up for the award for Best Actress in a Drama Television Series. This is Aniston’s fourth Golden Globe nomination—and yes, she was nominated twice (and won once!) for Friends. The actress is now getting some recognition for her dramatic work, after being nominated for her role in Cake in 2015. Even if she doesn’t snag the win, her chic ensemble deserves all the awards.

People may feel a flip-flop in their chest when they're under stress, haven't slept well or even during normal activity. They may say, "I felt my heart stop for a second." But in most cases, that heart-stopping feeling is actually an extra heartbeat, called a premature ventricular contraction (PVC).

They're very common. Some people feel them, but others don't."

Dr. Sarah Hussain, cardiac electrophysiologist with Penn State Heart and Vascular Institute

PVCs most often originate in the bottom chambers of the heart. "A PVC is a wider looking heartbeat," said Barbara Bentz, a certified registered nurse practitioner with the Heart and Vascular Institute. "That extra beat is almost always followed by a pause, which occurs when the heart resets back to its normal beat."

For people who feel PVCs, they can seem frightening. "They are not always dangerous," Hussain said.

Causes of PVCs can vary. They may occur in high-adrenaline situations, triggered by stress or anxiety. Others may be side effects from certain medications. Sometimes electrolyte imbalances can cause PVCs. So can too much caffeine or alcohol.

PVCs can occur at any age, young or old. The causes of PVCs often varies depending on the age of the patient.

PVCs become more of a concern if they happen frequently. "If more than 10% to 15% of a person's heartbeats in 24 hours are PVCs, that's excessive," Bentz said. The more PVCs occur, the more they can potentially cause a condition called cardiomyopathy (a weakened heart muscle).

People who have experienced a prior heart attack-;or those already diagnosed with cardiomyopathy-;should also take PVCs seriously. So too should people who experience symptoms, which can include chest pain and shortness of breath, in addition to palpitations or skipped heartbeats.

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The first step in diagnosing PVCs-;and learning whether they need treatment-;is an electrocardiogram (ECG), performed in a primary care doctor's office. A physician may recommend a wearable cardiac (Holter) monitor that will record a person's heartbeats over a 24-hour period. "That will quantify how many PVCs someone is having and the frequency of their PVCs," Hussain said.

In some cases, doctors may order an exercise stress test to see whether PVCs become worse with exertion.

Treatment for PVCs depends upon their cause. "If people only experience them when they have a large cup of coffee, then reducing caffeine intake is likely the answer," Bentz says. Other lifestyle changes may include reducing alcohol or energy drink consumption.

For people experiencing frequent PVCs, medications such as beta blockers, which slow heart rate, or calcium channel blockers, which relax the heart, may reduce the number of extra beats. Antiarrhythmic medications may also be used. If medication isn't effective or well tolerated because of side effects, doctors may recommend a minimally invasive procedure called cardiac ablation. It cauterizes the spot in the bottom chamber of the heart that causes the PVCs.

While most PVCs are harmless, people who experience any irregular heartbeat should call their doctor's office. "It may be PVCs or another type of arrhythmia," Hussain says. "So always ask to be evaluated and get an ECG."


Penn State Health

Chelsea Handler loves a good core challenge—so says the comedian/actor/TV host herself, as well as her trainer Ben Bruno, who’s worked with Handler for the last three years.

“I always harass my trainer @benbrunotraining for never working my abs hard enough,” Handler recently wrote on Instagram. Bruno, who also trains Kate Upton and Victoria’s Secret Model Barbara Fialho, confirmed the claim: “Ever since I’ve trained Chelsea she’s complained that the ab work I give her isn’t hard enough,” the Los Angeles-based trainer wrote in a repost on his own Instagram.

The solution? An unnamed, tough-as-hell core move that Bruno gave Handler last week. It’s an advanced variation of a V-hold made even tougher with a single-arm overhead shoulder press.

“This works and it hurts,” wrote Handler, when sharing a video via Instagram of her demo’ing the grueling exercise.

“I may have finally shut her up with this one,” Bruno wrote when reposting the video, which you can check out via @benbrunotraining here:

The exercise primarily targets your core, but it also engages major muscles in your upper and lower half.

Specifically, the move works your pectorals, deltoids, triceps, rectus abdominis (aka, your abs, the muscles that run vertically on your abdomen), obliques, thoracic spine (the upper and mid-back), lumbar spine (lower back), hip flexors, quads, and hamstrings, Mark DiSalvo, NYC-based certified strength and conditioning specialist, tells SELF.

“It’s definitely a muscle stimulator,” Clancy says. “You’ll really feel the midsection and surrounding areas and shoulders.”

It requires a high level of core stability—which is why it's so challenging.

“This is a very advanced move,” Mike Clancy, NYC-based certified strength and conditioning specialist, tell SELF. It requires a huge amount of core stability to do.

To perform this move correctly, you have to “keep a steady torso and avoid twisting or falling backward, which is much easier said than done,” Bruno wrote.

This requires continual contraction of your frontal core muscles (mainly, your abs) as well as the muscles in your mid and lower back. You’ll also need strength and flexibility in your hamstrings and calves to be able to lift and extend your legs, and keep them extended, says DiSalvo.

Sneaky balance work is also at play.

Because your tailbone is the only body part making contact with the ground while your entire core tries to hold steady and your upper body performs a weighted movement, this exercise requires a certain level of balance and spatial awareness to master, says DiSalvo.


This balance component makes the core stabilization that much more challenging. Doing a balance-intensive move like this really ignites your core stabilizing muscles, and smaller core muscles in general, that are usually “very foreign to people,” DiSalvo says. These oft-neglected muscles become the major forces that keep your body upright during a complex balance and stability move like this.

The one-arm dumbbell presses make the move even more difficult.

“This off-balance strength training movement requires further core stabilization,” explains Clancy. By adding in the dumbbell press with just one arm at a time, “you’re creating an imbalance in your upper body and you have to really activate your core to keep yourself from tipping over.”

In other words, this is move pretty much all about that core stabilization, which makes it an incredible—and incredibly difficult—total-body exercise.

When performing this move, going slow is the key to success. You can’t rush through the overhead presses, otherwise, you’d risk losing your balance. “This can help you learn how to better control your shoulder movements, especially during the eccentric phase [i.e. when you’re lowering the weight down],” says Clancy.

Because Handler’s move is very advanced, here’s a four-step progression that can help you work up to it.Dead Bug

  • Lie faceup with your arms extended toward the ceiling.
  • Lift your legs over your hips and bend your knees so your legs are at 90-degree angles.
  • Contract your core and press your lower back into the floor. Take a deep breath in.
  • Keeping your core tight and your lower back pressed to the floor, exhale and slowly extend your left leg toward the floor while bringing your right arm overhead.
  • Slowly return your arm and leg to the starting position.
  • Repeat with your opposite arm and leg. Continue alternating movements for 30 to 60 seconds.

This basic core move works your rectus abdominis and your transverse abdominis (the deepest ab muscle that wraps around your sides and spine) as well as your hips and shoulders, says DiSalvo. Your lower back should stay pressed to the floor as you perform this move. Think about pressing your spine down every time you exhale.

Once you’re able to do this move for at least 60 seconds continuously, you’re ready for the next move.

V-up Hold

  • Sit on the ground with your legs stretched out in front of you, your butt firmly planted, and your hands resting by your sides.
  • Make sure your core is tight, your chest is elevated, your shoulders are down and back (not hunched), and your head is naturally in line with your spine.
  • From here, lift both legs off the ground, keeping them as straight as you can.
  • Lift both hands off the ground so that your tailbone is the only point of contact with the ground.
  • Lean your torso slightly backward so that your body forms a V shape.
  • Hold this position for 30 to 60 seconds.


If you feel intense tension in your spine as you reach the V position, bend your knees slightly to take the pressure off, says Clancy.

Once you’re able to easily hold this position for at least 60 seconds (preferably 90 or more), you’re ready for the next move.

V-up Hold With Twist

  • Sit on the ground with your legs stretched out in front of you, your butt firmly planted, and your hands resting by your sides.
  • Make sure your core is tight, your chest is elevated, your shoulders are down and back (not hunched), and your head is naturally in line with your spine.
  • From here, lift both legs off the ground, keeping them as straight as you can.
  • Lift both hands off the ground so that your tailbone is the only point of contact with the ground.
  • Lean your torso slightly backward so that your body forms a V shape.
  • Once you’re in this position, start slowly twisting your shoulders—a few inches to the left and then a few inches to the right. Each twist should take 3 to 5 seconds.
  • Try to keep you core and legs as still as possible as you perform the twists so that your shoulders and upper back are the only moving parts.
  • Continue twisting for 30 to 90 seconds.

Once you easily can do this for at least 90 seconds, you can try the next step—Handler’s move.

Advanced V-Hold With Overhead Shoulder Press

  • Sit on the floor next to a dumbbell, with your hips square, legs stretched out in front of you, butt firmly planted, and hands resting by your sides.
  • Make sure your core is tight, your chest is elevated, your shoulders are down and back (not hunched), and your head is naturally in line with your spine.
  • From here, lift both legs off the ground, keeping them as straight as you can. Lift both hands off the ground so that your tailbone is the only point of contact with the ground.
  • Lean your torso slightly backward so that your body forms a V shape.
  • Grab the dumbbell in your right hand, palm facing away from you. Curl your bicep up and bend your elbow to bring the dumbbell to shoulder height, while maintaining good posture and balance. Extend your left arm straight up and out to the side. This is the starting position.
  • Press the dumbbell straight up toward the ceiling for one count, and bring it back down for two to four counts. This is 1 rep.
  • Do 3 to 10 reps on each side and then switch arms for another 3 to 10 reps.


Some people, like Handler, may be able to fully extend their legs in the V position. That’s great—but it’s totally OK if you’re not at that level. As Bruno writes, “You’ll want to start with bent knees, a more upright torso, and the feet hovering just off the floor. As you improve, you can straighten the legs, raise the feet, and lean back like Chelsea is doing here.”

If your shoulders feel pinched and/or you can’t extend your elbow all the way as you attempt the presses, your shoulders are likely internally rotated too far forward (aka hunched), says DiSalvo. “Lots of people have internally rotated shoulders and you may not be able to fix this on the spot.” If that’s the case, put the weight down and reset your positioning.

When readjusting yourself, “you want to visualize your sternum coming forward and your shoulders dropping slightly," says DiSalvo. Think about keeping your core tight and lower back flat, and try not to throw your belly forward, he adds.

Doing the moves in this progression will help strengthen and stabilize your core, while also working many major muscles in your upper and lower half. Just know: Handler's move is seriously advanced, so for most of us, it will take some time and dedication to nail.

If you haven’t had a movie night with your BFFs where you all sit there and laugh hysterically at Booksmart, what are you even doing with your life? It’s definitely in my top ten films of 2019, and a lot of that is due to the part my queen Beanie Feldstein plays. Not only is the actress nominated for her role in the film, but Beanie Feldstein’s 2020 Golden Globes look is worthy of its own award.

Dressed in an absolutely stunning navy gown, Feldstein strutted the red carpet. The dress actually reminds me of what I wore to prom junior year of high school, but elevated a million times over. The bodice was perfectly beaded with gorgeous sequins, and the color was absolutely *chef’s kiss.* The last time Beanie Feldstein was on the Golden Globes red carpet was many moons ago accompanying her brother, Jonah Hill. For the 2020 Golden Globes, the actress held her damn own, and I couldn’t be happier with this classic look.

Rob Latour/Shutterstock.

Sticking to the navy theme, Beanie Feldstein donned the navy Twist Headband from BaubleBar (We love a hair accessory!) and navy earrings. It was the sparkly monochromatic look of my dreams. I truly wish 17-year-old me headed to prom could have seen this beautiful ensemble before she walked out the door. At least nowadays I have Beanie Feldstein’s red carpet looks for all my fashion inspiration.


While Beanie Feldstein could totally be nominated for her outfit alone, the actress is up for Best Performance by An Actress in a Comedy or Musical Motion Picture. Her work in Booksmart is funny, smart and totally relatable, and she is definitely worthy of this award. This may be Beanie Feldstein’s first Golden Globe nomination, but I have a very strong feeling it won’t be her last. I cannot way to see what the actress does in 2020.

The United States has sent nearly 17.8 tons of medical supplies to China, including masks, gowns and respirators, a State Department official said.

An American became the first confirmed non-Chinese victim of the new coronavirus on Saturday while a Japanese man also died with symptoms consistent with the disease, as the epidemic looked set to pass the death toll from the SARS pandemic in rapid time.

The 60-year old U.S. citizen diagnosed with coronavirus died at Jinyintan Hospital in China’s Wuhan, the epicentre of the virus outbreak, on Feb. 6, a U.S. embassy spokesman in Beijing said.

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“We offer our sincerest condolences to the family on their loss,” the spokesman told Reuters. “Out of the respect for the family’s privacy, we have no further comment.” A Japanese man hospitalised with pneumonia in Wuhan also died after suffering flu-like symptoms consistent with the new coronavirus, Japan’s foreign ministry said.

The man in his sixties was suspected of having been infected with the coronavirus but due to difficulties in diagnosing the disease the cause of death was given as viral pneumonia, the ministry said citing Chinese medical authorities. As of noon on Thursday, 17 foreigners were being quarantined and treated for the disease in China, according to government figures. No updated figures were immediately available.

The total death toll in mainland China rose by 86 to 722 on Saturday, according to Chinese authorities, and is poised to pass the 774 deaths recorded globally during the 2002-2003 pandemic of Severe Acute Respiratory Syndrome (SARS), another coronavirus that jumped from animals to humans in China.

During the SARS outbreak between November 2002 and July 2003, the number of reported cases was 8,098, suggesting a far lower transmission rate than the latest coronavirus, but a higher mortality rate.

So far only two deaths have been reported outside mainland China – in Hong Kong and the Philippines – from about 332 cases in 27 countries and regions. Both of those victims were Chinese nationals.

“It is hard to say how lethal this novel coronavirus infection is,” Professor Allen Cheng, an infectious diseases expert at Monash University in Melbourne, told Reuters.

“While the crude mortality appears to be around 2%, there are likely to be many people who have been infected that haven’t been tested … We probably won’t know the true case fatality for some time yet.”

Hubei officials on Saturday reported 81 new deaths, 67 of those in Wuhan, a city under virtual lockdown. Across mainland China, excluding the 2,050 people who had recovered and those who had died, the number of outstanding cases stood at 31,774.

Beijing’s communist leadership has sealed off cities, cancelled flights and closed factories to contain the epidemic, with ripple effects for global markets and businesses dependent on the world’s second-biggest economy.

Saturday marked the final day of the Lunar New Year celebrations, usually characterised by family gatherings, fireworks, riddle-guessing and the lighting of lanterns.

This year, most people were eating dumplings, a traditional custom, at home alone. On national television a gala show will feature recitation of poems on counter-virus efforts instead of the usual music and dancing.

News of the death on Friday of Li Wenliang, a doctor who raised the alarm about the new coronavirus, sorrow and outrage on Chinese social media and rekindled memories of how Beijing was slow to tell the world about the SARS outbreak.

Li, who succumbed to the disease in a Wuhan hospital, was among eight people reprimanded by police in the city for spreading “illegal and false” information after he shared details of the virus with colleagues.


Hong Kong was introducing on Saturday quarantine for two weeks for all people arriving from the mainland, or who have been there during the last 14 days.
Matthew Cheung, chief secretary for administration, said that Hong Kong people returning from the mainland must stay home for a fortnight or risk a HK$25,000 ($3,200) fine and 6 months’ jail.

Non-Hong Kong residents must stay in government isolation centres or hotel rooms for the same period, facing the same penalties. While China is bearing the brunt, anxiety levels are spiking across Asia, with Japan alarmed by the rising number of cases aboard a quarantined cruise ship, major foreign companies pulling out of an international airshow in Singapore, and Thailand losing money as Chinese tourists stay home.

Another three people on the cruise liner off Japan tested positive for coronavirus, bringing the total number of confirmed cases from the ship to 64, Japan’s health ministry said.

Taiwan and Hong Kong urged residents not to hoard goods such as toilet paper amid signs of panic buying, and the World Health Organization (WHO) chief warned of worldwide shortages of medical gowns, masks and other protective equipment.

Royal Caribbean Cruises Ltd on Friday banned “any guests holding a Chinese, Hong Kong or Macau passports, regardless of when they were there last” from boarding the company’s ships.

WHO emergency expert Mike Ryan said reports of Asians being shunned in the West over a perceived connection to coronavirus was “utterly and completely unacceptable and it needs to stop.”

Taiwan’s government said that starting from Monday it would suspend all direct passenger and freight shipping between the island and China. It had already decided to suspend most flights from Monday between Taiwan to China.

Hundreds of foreigners have been evacuated out of Wuhan over the past two weeks. A second evacuation plane to airlift Australians out of Wuhan was delayed after China did not give it clearance to land, Australian officials said on Saturday. Global equity markets and government debt yields slumped on Friday, as growing concerns about the virus’ impact on global growth overshadowed a strong U.S. jobs report.

Apple Inc, however, said it was working to reopen its China corporate offices and call centres next week, and was making preparations to reopen retail stores there. U.S. Secretary of State Mike Pompeo on Friday said the United States was prepared to spend up to $100 million to assist China and support coronavirus efforts by the WHO.

The United States has sent nearly 17.8 tons of medical supplies to China, including masks, gowns and respirators, a State Department official said.

The WHO said out of $675 million it is seeking for its coronavirus response through April, it has received pledges of $110 million, $100 million of that from the Gates Foundation.