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Shared savings programs can sharpen health care providers' focus on value, but they are not scalable business models for hospital and health systems, says Patrick Runnels, chief medical officer at University Hospitals in Cleveland. Case in point: Although University Hospitals earned about $50 million through shared savings last year, the amount was less than 5% of the health system's total revenue, Runnels notes. The CMS should increase shared savings percentages, adjust fee-for-service rates and temporarily pay more for reducing low-value services if shared savings models are to be scalable business models, Runnels says.
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Harness dormant customer data goldmines trapped within disconnected systems. A trusted identity setup is key for a panoramic perspective. Unite your information to cultivate enhanced growth, vital insights, and a strategic edge. Download the whitepaper now.
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The CMS has set a flat reimbursement rate of $127.28 per square centimeter for skin substitutes, shifting away from the previous payment model of the average sales price plus 6%. The new payment policy is expected to reduce Medicare spending on the products by 90% or more, and some clinicians say it will improve patient care and outcomes, but an industry group spokesperson says it may encourage the use of inferior products.
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Fifty percent of health care practices use at least one artificial intelligence tool, and 72% of those practices use AI for clinical documentation, according to a survey of 887 health care professionals. More than half of respondents expect to start using AI for revenue cycle management, and around 76% see promise in smart glasses.
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Telemedicine can improve psychological well-being and quality of life for patients with dementia, ease symptoms of depression and anxiety and alleviate caregiver burdens, according to a review in JMIR Mental Health. However, the effectiveness can vary and is less beneficial for people with advanced dementia or those without adequate support.
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Facing labor gaps and high customer demands, retailers can innovate operations with mobile technology—enabling real-time insights, contactless payments, digital receipts, and loyalty programs. Dive into this paper to see how mobile solutions can enhance retail operations and engage shoppers.
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Denied claims are not simply a cost of doing business or an accounting nuisance, writes Neal Shah, a health care researcher and chairman of Counterforce Health. Each denial contains valuable data, and AI can help clinics and small practices learn from denied claims -- and reduce denials -- by mining and analyzing actionable data, Shah writes. Health care providers can also change their workflows, build feedback loops, scale automation, leverage partnerships and elevate denials to the C suite to get denials under control.
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| (Yuichiro Chino/Getty Images) |
Journalist Evan Ratliff created a fictional startup called HurumoAI staffed entirely by AI agents to see how well the technology could manage a business. The project quickly became chaotic, with the AI agents organizing an off-site gathering without permission. The team developed a prototype for a "procrastination engine" called Sloth Surf, but much of their reported progress was fabricated. The exercise demonstrates how much better AI agents need to be before they can replace people.
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The CMS debuted a beta version of a national health care provider directory at recent conference in Washington, D.C. The directory is designed to help Medicare beneficiaries locate health care providers who accept Medicare. The directory is based on FHIR standards and will be accessible through a free app. HealthEx also demonstrated its health records access platform.
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