Wed.Dec 13, 2023

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Class action lawsuit accuses Humana of using AI algorithms to restrict access to care

Fierce Healthcare

A newly filed lawsuit alleges that Humana used artificial intelligence algorithms to deny key rehabilitation care for seniors. | A newly filed lawsuit alleges that Humana used artificial intelligence algorithms to deny key rehabilitation care for seniors.

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Humana used algorithm to deny care to Medicare Advantage patients, lawsuit claims

Health Care Dive

It's the latest insurer to face a suit over its use of algorithms when appraising claims.

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'It can be life or death': Microsoft's Peter Lee on the power, dangers of GPT-4 in medicine

Fierce Healthcare

Addressing a room of healthcare professionals at the IHI Forum on Wednesday, Peter Lee, corporate vice president of research and incubations at Microsoft, opened by saying the audience was possibly | It is wrong to think of large language models like GPT-4 as traditional computers—they are reasoning engines and can make mistakes like humans do, the tech giant's corporate vice president of research and incubations warned IHI Forum attendees.

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Google reveals new generative AI models for healthcare

Health Care Dive

MedLM, which currently includes two models, has been tested by HCA and Accenture.

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How to Battle Layoffs: The Career Star Accelerator Bootcamp

Facing layoffs in your organization? Support your team members' career transition with Career Star Accelerator Bootcamp: Custom Resume & LinkedIn Revamp + 6 Weeks of Career Coaching. Our certified resume writers will create job search-winning resumes and LinkedIn profiles while they work with a career coach to learn unique strategies to stand out, attract the right employers, automate their job search, and land their dream job.

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Payers' increasing claims denials, delays 'wreaking havoc' on provider revenue cycles

Fierce Healthcare

A jump in claim delays and denials is “wreaking havoc on providers’ revenue cycle performance” and contributing to health systems’ “volatile” accounts receivable and diminishing cash reserves, acco | More frequent pushback from commercial and Medicare Advantage payers is complicating patient self-pay collections and, ultimately, undermining the revenues and cash reserves of hospitals, health systems and physician groups, according to a pair of recent reports.

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KKR in talks to buy stake in healthcare data analytics firm Cotiviti: WSJ

Health Care Dive

The deal would value Cotiviti at around $11 billion.

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P3 Care Brings Exclusive Holiday Discount Offer For Medical Practices

p3care

This approaching holiday season, P3 Care is here with warm wishes for all the medical providers. Meanwhile, we are truly filled with the spirit of giving in our joyous celebrations of the holiday season. Our medical billing outsourcing company in USA has earned a name for its valued medical billing services. Along with this, we provide other services like medical credentialing, A/R management, etc.

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Virtual doula care improves outcomes on par with in-person care, Maven study finds

Fierce Healthcare

Virtual doula care improves birth experiences and reduces the odds of a cesarean section at rates comparable to in-person doula care, a new study finds. | The odds of a C-section decreased notably with several doula visits on the Maven platform, and more so for Black members.

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Supreme Court to rule on abortion pill access

Health Care Dive

The court's decision on mifepristone, expected by June, could have far reaching implications for the FDA.

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Back to normal? Health care spending growth rates down from pandemic era

Fierce Healthcare

Healthcare spending has increased 4.1% to $4.5 trillion, or $13,493 per person, according to a new report from the Centers for Medicare & Medicaid Services published in Health Affairs. | Health care spending increased to $4.5 trillion in 2022, or $13,493. Here's how that breaks down.

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5 Essentials for Healthcare CIOs: A Provider Data Management Checklist

Complete and accurate provider data is essential for health organizations to operate effectively. A better understanding of your provider network helps to understand patients and consumers, identify gaps in care, and make the best possible decisions for your businesses. A modern provider data management solution should power a complete and accurate view of each of your providers, make this data easily accessible across functional groups, and be flexible and agile enough to scale. with your needs

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Home Health Spending Begins To Climb Again Post-Pandemic

Home Health Care

After stalling in 2021, spending on home health care returned to a more normalized growth rate in 2022, according to a new analysis from the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS). Specifically, national health expenditures on home health care increased by 6% to $132.9 billion in 2022. In 2021, spending only increased by 0.3%.

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Supreme Court to hear case challenging abortion pill access, FDA authority

Fierce Healthcare

The Supreme Court announced Wednesday morning that it will weigh in on a months-long legal dispute determining the availability of mifepristone, which is used in more than half of all abortions in | The highly anticipated decision will mark the top court's first return to the issue of abortion since last year's landmark Dobbs v. Jackson ruling.

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Augmedix Integrates Google Cloud AI to Boost Medical Documentation

HIT Consultant

What You Should Know: – Augmedix , a leader in ambient medical documentation, is partnering with Google Cloud to integrate MedLM , a new healthcare-focused generative AI model, into its technology stack. – This strategic integration partnership aims to improve the quality and efficiency of medical note generation, ultimately benefiting healthcare providers and patients alike.

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KKR in talks to buy stake in analytics firm Cotiviti in a deal valued at $11B: media report

Fierce Healthcare

Private equity firm KKR & Co. is exploring a potential deal to buy a stake in healthcare analytics company Cotiviti from Veritas Capital, The Wall Street Journal reported Monday. | Private equity firm KKR & Co. is exploring a potential deal to buy a stake in healthcare analytics company Cotiviti from Veritas Capital, The Wall Street Journal reported Monday.

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Level up Culture & EQ | Sign up for the #CultureDrop

Once a week, culture & leadership expert Galen Emanuele gives free, actionable EQ training in 5 minutes or less. Subscribe to the #CultureDrop and access free resources & content.

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Interest rates are falling

Healthcare ECONOMIST

…well, real interest at least. While in the years since the COVID-19 pandemic have seen nominal interest rates rising, in the long run real (i.e., inflation adjusted) interest rates are falling. A NBER working paper by Obstfeld (2023) provides compelling evidence of this trend. Current real interest rates are likely somewhere in the 1%-2% range.

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Sandata: Technology’s Role in Moving Homecare into The Future

Fierce Healthcare

Emmet O'Gara, CEO of Sandata, a pioneer and market leader in homecare solutions, joins Fierce Healthcare in the hot seat to share insights into how homecare agencies, MCOs, and other industry stake | Emmett O'Gara, CEO of Sandrata, is passionate about leveraging technology as a force for good in home care. In this interview, she argues the case for an open model system to drive interoperability and remove administrative burdens for MCOs.

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The Crucial Role of Dual Incident Response Playbooks in Healthcare Cybersecurity

HIT Consultant

As the Chief Information Officer (CIO) of a large hospital system, it is my responsibility to lead the charge in cybersecurity preparedness, and I have done this through a nuanced approach to incident response planning. In an era where healthcare organizations heavily rely on digital systems and sensitive patient data, the threat of cybersecurity incidents looms large; the importance of incident response procedures cannot be overstated.

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Testing the Waters: Using Wastewater Surveillance as an Early Warning System

The Rand Blog

A global consortium to fund sentinel and community surveillance systems and enable global data sharing was established at the International Wastewater Surveillance Conference in November. Success will require bringing together the knowledge being amassed to combat the fracturing of pathogen surveillance and to enable effective early warning between countries.

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A Guide to Improved Sepsis Detection & Compliance: 6 Areas You Should Address

This guide highlights key areas that your sepsis detection platform should address to minimize the impact of this leading, entirely preventable cause of in-hospital deaths, as well as how to increase compliance by 20% in 30 days. Download to learn more!

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What Patients Want: Zocdoc’s Report Reveals Patient Preferences

HIT Consultant

What You Should Know: – Zocdoc , the healthcare marketplace, has released its inaugural What Patients Want Report , offering valuable insights into what patients seek from their healthcare experience and providers. – Based on millions of bookings and patient interactions, the report paints a picture of how patients are navigating the healthcare landscape today, and what they expect from their providers and the industry at large.

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How Nova Leap, Avid Health at Home Grew Quickly, Effectively Through Acquisition

Home Health Care

This article is a part of your HHCN+ Membership Home care providers looking to grow need to follow meticulous planning – and also have realistic goals. During the public health emergency, when more attention was being paid to alternative settings for long-term care, the home care industry saw record-breaking volume and valuations. Sign up for HHCN+ to read this exclusive content.

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1 in 3 Primary Care Physicians Have Already Tried AI Scribe Tools

HIT Consultant

What You Should Know: Elation Health , the clinical-first technology company powering innovation in primary care, today announced the results of a survey of 229 primary care physicians focused on the benefits, desired features, and hurdles to adoption of artificial intelligence–powered (AI) medical scribe tools in the EHR. AI scribe tools use speech recognition and natural language processing to capture and transcribe conversations between a physician and a patient during clinical encounters.

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Class-Action Lawsuit Accuses Humana Of AI-Driven, Post-Acute Care Claim Denials

Home Health Care

A class-action lawsuit was filed against Humana Inc. (NYSE: HUM) in Kentucky on Tuesday. The company is the latest insurer under fire over its alleged utilization of AI to dictate or deny post-acute care. Humana Medicare Advantage (MA) beneficiaries, specifically, filed the lawsuit, alleging that the company illegally used algorithms to limit post-acute care services.

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The New Tech Experience: Innovation, Optimization, and Collaboration

Speaker: Paul Weald, Contact Center Innovator

Learn how to streamline productivity and efficiency across your organization with machine learning and artificial intelligence! No matter what industry you're in - healthcare, customer service, sales, and more - it’s easier than you think to reduce wait times, monitor sentiment, and provide enhanced self-service options for all of your users. This means that you can achieve a more consistent and engaging customer experience while reducing sources of friction.

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Twin Health Secures $52M to Expand Whole Body Digital Twin Tech

HIT Consultant

What You Should Know: Twin Health, creators of the Whole Body Digital Twin™ service for reversing, improving, and preventing chronic metabolic diseases, announced securing $50 million in funding to continue expanding its groundbreaking technology and clinical service solutions for more members across the United States. Twin Health introduced the Whole Body Digital Twin, a dynamic model of each individual’s unique metabolism, powered by artificial intelligence, that is built from thousands of dat

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Lessons in patient partnership from a patient and health communications expert

Healthy Debate

Organizations that meaningfully involve diverse patient input stand to gain immensely and could lead the way for other institutions.

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Amino Health Appoints John Asalone as CEO, David Vivero Transitions to Chairman

HIT Consultant

What You Should Know: – Amino Health , a digital healthcare navigation company, today announced the appointment of John Asalone as Chief Executive Officer, effective immediately. Asalone succeeds David Vivero, the company’s founder and CEO, who will transition to the role of Chairman. – Asalone joined Amino in August 2023 as COO and brings 20 years of experience scaling software and marketplace companies.

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A Precarious Moment for Yemen's Truce

The Rand Blog

The truce in Yemen is imperfect, but it is the only barrier currently preventing the country from sliding back into widespread war. A comprehensive negotiation process is the most viable option for peace in Yemen in the near term, and the only barrier to the humanitarian devastation that a full-scale resumption of the war in Yemen would surely bring.

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Strategies to Deal with Collaborative Healthcare Communication

Speaker: Dr. Ugo Uwaoma, MD, MBA

Due to the impact of COVID-19, integrating telehealth software into practices and organizations has become the new normal. In turn, this has increased the effectiveness of collaborative healthcare by strengthening communication amongst healthcare workers and helping combat the woes of burnout. Communication between patients and healthcare providers has also improved, allowing patients to reach their providers easily and decreasing turnaround time.

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Google Cloud Launches Healthcare Focused Generative AI Models

HIT Consultant

What You Should Know: – Google Cloud unveils MedLM , a family of generative AI models specifically designed for medical applications. – Building on the success of Med-PaLM, Google’s latest offering promises to revolutionize medical documentation, drug research, and patient care experiences. MedLM Background Built on the foundation of Med-PaLM 2, MedLM offers two model sizes: a larger one for complex tasks and a smaller one for scaling across various applications.

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Treat Psychedelics Like Cannabis?

The Rand Blog

Similar to cannabis a decade ago, the United States is in the early days of legalizing some psychedelics for nonmedical purposes. Now is the time to make thoughtful choices.

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Americans Wary of Generative AI in Healthcare: Trust and Transparency Key to Adoption

HIT Consultant

What You Should Know: – A new survey, Generative AI in Healthcare: Gaining Consumer Trust, from Wolters Kluwer Health reveals significant concerns among Americans regarding the use of generative AI (GenAI) in healthcare. – While many see its potential to improve care, the lack of transparency and validation around data sources raises major trust issues.

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Singapore to Pass Comprehensive Health Data Law

Triage Health Law

On December 4, 2023, Singapore’s Ministry of Health (Ministry) announced that the nation’s first ever comprehensive health data law, the Health Information Bill (Bill), will be introduced in mid-2024. A set of Cyber & Data Security Guidelines for Healthcare Providers (Guidelines) was also published. Of particular importance is that these Guidelines will frame and eventually be imposed as regulatory requirements under the Bill.

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Top 12 Telehealth KPIs Every Health Tech Leader Should Know

Speaker: Matt McBride, CEO and Co-Founder of Mend

Patient engagement happens before, during, and after interactions. Consumer research has found that in 2021, 64% of US households reported using Telehealth services. In addition 34% of patients would prefer Telehealth visits to in-office visits. Accessible patient engagement technology can help you improve your relationships with your patients while also improving your KPIs.