Generative artificial intelligence can identify social determinants of health within EHR notes, accurately and without bias, determining which patients might need extra support, according to Somerville, Mass.-based Mass General Brigham. The health system’s researchers fine-tuned large language models to automatically extract information about social determinants — factors such as housing, employment and family status that…
No matter how large or well-resourced a health system may be, making the right care decisions ultimately depends on its ability to exchange information with healthcare’s “digital have-nots”—organizations that weren’t eligible for EHR implementation incentives, like post-acute facilities, home health, substance use disorder clinics and assisted living facilities. When these technology connections don’t exist, this…
The Centers for Medicare & Medicaid Services (CMS) has approved New York state’s amendment of its ongoing Medicaid transformation efforts to allow the state to advance health equity, support the delivery of health-related social needs (HRSN) services, and promote workforce development. The state said the waiver would enable New York to invest nearly $6 billion…
Going into the 12th year since it brought accountable care into the healthcare lexicon, the Medicare Shared Savings Program (MSSP) continues to evolve, with CMS making changes and participants fine-tuning best practices. Starting with 220 accountable care organizations (ACOs) in 2012-13, the MSSP grew to 561 in 2018. However, the number has been below 500…
2023 Signaled Several Emerging Trends Across the Healthcare Provider Space The clash between payors and providers intensified, demanding strategic precision. Generative AI, which stepped into the spotlight in 2023, now commands a pragmatic examination of its impact on care delivery. Private equity’s abrupt reckoning with outlandish valuations demands a necessary recalibration. The rise of capitated…
Wound care innovations help providers care for patients After nearly a decade in the wound care world, I still continue to be amazed, surprised and inspired. It’s been a time I’ve thoroughly enjoyed– getting a front-row seat to innovations, seeing the remarkable commitment of providers, and marveling at the constant effort from all I meet…
Phoenix-based Equality Health offers value-based care solutions dedicated to serving independent primary care practices in closing gaps in care. Last June, I had the opportunity to interview Mark Stephan, M.D., M.B.A., the company’s chief medical officer, about Equality Health’s ’Medicaid-first” business model. “The way we enter markets is in the Medicaid space, but we also…
A headline you’ve likely read in the last two months sounds something like this: “In its 10th performance year, the Medicare Shared Savings Program (MSSP) saved Medicare $1.8 billion after accounting for shared savings and losses.” It probably goes on to talk about physician-led accountable care organizations (ACOs) trumping non-physician-led ACOs, and low-revenue ACOs trumping high-revenue ACOs—trends…
According to critics, a decade of value-based care (VBC) efforts have proven an abject failure, improving neither cost nor quality of healthcare. Over 50 VBC program implementations have collectively lost billions of dollars as compared to traditional fee-for-service (FFS) benchmarks, they say, and can boast little to no clear improvement in quality outcomes. In short,…
Now in its seventh year, the Merit-Based Incentive Payment System (MIPS) continues to create confusion, especially for specialists. The program can have a big impact on Medicare Part B reimbursements, using the MIPS composite performance score to determine if providers will receive a payment bonus, a payment penalty, or no payment adjustment at all. Adjustments are…