Providers utilize business intelligence to monitor referral patterns and collaborate with clinicians who order their services. Such analytics tools have also been deployed in the specialty to improve productivity, track patient satisfaction and bolster quality.
Independence Blue Cross, the largest medical insurance provider in the Philadelphia area, does not admit to wrongdoing. It was accused in a lawsuit backed by the U.S. Department of Justice of misrepresenting the severity of patient illnesses to juice risk-adjusted Medicare payments.
With its $350M in new funding, EliseAI said it plans to build out its technology and sales force. It currently works with specialty provider groups to automate practice operations such as scheduling and insurance verification.
Of surveyed and interviewed U.S. physicians who showed significant six-month improvement in follow-up vs. baseline wellness checks, 47% attributed the gain to active personal changes. Not far behind were those who credited active work-related changes—40% of the field.
The new entity, Precure, will be owned by both groups. Its work in detecting early disease for timely intervention stems from a research project launched this summer. The Mayo Clinic said Precure will make the results of that initiative actionable.
The Department of Health and Human Services is looking to replace lab animals with AI models. Even more bullish on AI is the new boss at the Centers for Medicare and Medicaid Services.
GenAI initiatives are complex and—in some cases—costly. “As such, the main rationale for pursuing them needs to be business growth, not workforce reductions.”
The authors of the survey report note that AI tools mentioned by respondents run the gamut from automated appointment reminders to dynamic “care gap” messaging.
Some AI decision-support models have a proclivity for recommending aggressive care pathways. And doing so on the basis of patient demographics, not medical necessity.
In exclusive interviews, HealthExec spoke with the American Cancer Society about rising cancer rates, and a virtual provider service that's working to bolster struggling oncology staff.
A data analysis from the Physicians Advocacy Institute and Avalere Health found corporate buyouts are leaving patients in low-population areas with fewer options, as doctors are opting to go elsewhere.
Many if not most hospitals and other provider organizations take a decided interest in what their peer institutions are doing with AI. A major motivator for the keen curiosity is gauging how well one is keeping up with the Joneses. So to speak.