Autonomous inpatient coding. This may sound like a pipe dream for revenue cycle leaders, whose hopes were likely raised and crushed in the early aughts. But it's coming sooner than most think.
Why is true inpatient coding automation the "holy grail" – as Kerry Gillespie, a former CFO at Intermountain Health and now an executive consultant at Warbird Consulting Partners, said to me at a Healthcare Financial Management Association roundtable last year?
For decades, inpatient services have
Read More
Is ‘Float Pool’ Nursing the Way Out of the Staffing Shortage?
It’s no secret that health systems across the U.S. continue to struggle with the nurse shortage despite concerted efforts from federal officials to grow the workforce. Even before the COVID-19 pandemic, the U.S. Department of Health and Human Services projected that the demand for registered nurses would hit more than 3.6 million by the year 2030 – meaning that the field would have needed to add nearly 50,000 new registered nurses each year since 2014 to meet that demand.
While the use of
Read More
Strengthening Cybersecurity Preparedness for Small Organizations: Lessons from the Change Healthcare Ransomware Attack
Here we go again. The US health system is in a desperate cybersecurity state of affairs. Another healthcare cyberattack has made the news and it’s a big one. UnitedHealth Group’s technology unit, Change Healthcare, is currently facing an ongoing ransomware attack which has reverberated through healthcare systems and affected prescription deliveries. This should raise red flags for all healthcare organizations regardless of their size, but particularly for smaller organizations with
Read More
AI & Digital Twins: The Future of Disease Detection & Treatment
AI is impacting every aspect of our lives, and the healthcare industry is no exception.
With digital transformation a perennial focus for the sector, AI is increasingly being adopted to accelerate and enhance initiatives. From cost reduction to improved disease detection to personalized medicine, there are a wealth of benefits that the technology is unlocking, including supercharging digital twins.
Digital Twins and Healthcare
Digital twins have been around for several decades and are
Read More
Closing Care Gaps Through Prospective Risk Adjustment
The lack of a complete and comprehensive patient record limits the ability of the physician to improve care and puts organizations at financial and regulatory risk. The Centers for Medicare and Medicaid Services (CMS) estimated that for payment year 2018 alone, it will recover $428.4 million (net) and $4.7 billion from 2023 through 2032, including extrapolation effects. The HHS Office of Inspector General (OIG) recently reported that, from October 2014 through December 2016, 153 audit reports
Read More
Leveraging the AI Opportunity for Healthcare Unstructured Data
Unstructured data – such as medical images, scans and lab reports – opens the door to a wide range of exciting new possibilities in the world of healthcare. By deriving insights from unstructured data, healthcare organizations can deliver better patient care, as well as unlock powerful capabilities – like using AI models to streamline medical note-taking, reshape hospital billing and improve medical coding.
To do these things, however, you need to be able to track and access all your
Read More
Has TikTok Single-Handedly Changed Healthcare Professional Etiquette?
An Atlanta mother gave birth to a baby boy who was unintentionally decapitated during delivery in late 2023. Within hours of this unimaginable tragedy, the doctor performing the autopsy had posted photos of the baby to his social media accounts. It would seem to be common sense to most of us, medical professionals or not, that this is despicable behavior. We have to ask ourselves, what would compel an established, well-respected physician to post such traumatic and sensitive medical images to
Read More
Unlocking the Potential of Value-Based Care with AI
The momentum of value-based care (VBC) is poised to accelerate. The Centers for Medicare and Medicaid Services (CMS) has outlined an ambitious objective: to transition all traditional Medicare beneficiaries into a VBC arrangement by 2030, a notable increase from the mere 7% recorded in 2021 by Bain Research. As more plans, providers and members enter VBC arrangements, substantial volumes of clinical data will need to be managed effectively to oversee patient risk and care quality.
The
Read More
Rise of Retail Healthcare: Challenges and Opportunities for Payers
Healthcare delivery continues to evolve to meet ever-changing patient demands. Over the years, rural doctors who historically performed house calls have been replaced with regional physician groups and community hospitals that are owned and managed by large health systems with multiple locations. Nearly 70% of physicians now work for a corporate entity instead of private practices. Telehealth visits increased 26x during the COVID-19 pandemic and have since leveled off, but are still a preferred
Read More
Strengthening Healthcare IT Infrastructure: A Wake-Up Call for Cybersecurity Resilience
The recent cyberattack on Change Healthcare highlights the healthcare industry’s vulnerability when threatened with criminal attempts to disrupt technology and operations. The ransomware strike caused a chain reaction among healthcare providers, where payment systems were disrupted, cash flow halted, and—worst of all—patient safety was put in jeopardy.
For many healthcare providers, the incident reinforced the reality that cyberattacks targeted outside their organizations
Read More
