The Payment Integrity Game-Changer: Generative AI
The following is a guest article by Dr. Musheer Ahmed, Founder and CEO at Codoxo
New Generative AI Use Cases are Emerging, Including to Transform Healthcare Payments, it’s up to the Industry to Embrace Adoption for Next-Level Cost Containment Outcomes
The healthcare system in America is confronted with significant challenges, including a steep rise in healthcare expenditures. In 2023, healthcare costs are projected to surge by almost 6%. A vast majority of healthcare workers are reporting job burnout. While these and other obstacles may seem insurmountable, we are already seeing how advancements in technology — partic...
Source: EMR and HIPAA - February 9, 2024 Category: Information Technology Authors: Guest Author Tags: Administration AI/Machine Learning Ambulatory Health IT Company Healthcare IT Hospital - Health System Revenue Cycle Management Codoxo Dr. Musheer Ahmed Generative AI Healthcare ChatGPT Healthcare Costs Healthcare Generative AI P Source Type: blogs
The bias of reality
Stephen Colbert -- or rather " Stephen Colbert, " in his former character -- famously said that " Reality has a well-known liberal bias. " And so conservatives must deny reality, which as in the case of anthropogenic climate change means denying scientific findings, and the very integrity and authority of science. But that doesn ' t usually work very well with the courts --viz. the jury award of $1 million to climate scientist Michael Mann -- so they also result to scientific fraud.You may recall that U.S. District Judge Matthew Kacsmaryk ruled to suspend FDA approval of the abortion medication mifepristone,relying largely...
Source: Stayin' Alive - February 9, 2024 Category: American Health Source Type: blogs
Who to Blame for Health Costs: The Poisoned Chalice of “ Moral Hazard ”
By JEFF GOLDSMITH
How the Search for Perfect Markets has Damaged Health Policy
Sometimes ideas in healthcare are so powerful that they haunt us for generations even though their link to the real world we all live in is tenuous. The idea of “moral hazard” is one of these ideas. In 1963, future Nobel Laureate economist Kenneth Arrow wrote an influential essay about the applicability of market principles to medicine entitled “Uncertainty and the Welfare Economics of Medical Care”.
One problem Arrow mentioned in this essay was “moral hazard”- the enhancement of demand for something people us...
Source: The Health Care Blog - February 8, 2024 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Health Care Costs Jeff Goldsmith Kenneth Arrow Medicare Moral Hazard Source Type: blogs
Wednesday Bible Study: Moar genocide
Regarding Psalm 60, the meaning ofShushan Eduth is disputed. It means something like " Lilly of Testimony, " which doesn ' t make a lot of sense. It could be the name of a tune, but some authorities say it ' s the name of a city where Jews resided during the Babylonian exile, although that doesn ' t make much sense in context since this supposedly refers to a battle recounted in 1 Samuel 10, and repeated in 1 Chronicles 19. It could just be a metaphor for the content. Joab is one of David ' s generals, and like various passages in the Deuteronomistic History, this describes the massacre of the Moabites. Psalm 61...
Source: Stayin' Alive - February 7, 2024 Category: American Health Source Type: blogs
The Money ’ s in the Wrong Place. How to Fund Primary Care
By MATTHEW HOLT
I was invited on the Health Tech Talk Show by Kat McDavitt and Lisa Bari and I kinda ranted (go to 37.16 here) about why we don’t have primary care, and where we should find the money to fix it. I finally got around to writing it up. It’s a rant but a rant with a point!
We’re spending way too much money on stuff that is the wrong thing.
30 years ago, I was taught that we were going to have universal health care reform. And then we were going to have capitated at-risk entities. then below that, you have all these tech enabled services, which are going to make all this stuff work an...
Source: The Health Care Blog - February 5, 2024 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Matthew Holt ACA ACO CVS FQHCs Health Systems hedge funds Hospitals Medisync primary care Walgreens Walmart Source Type: blogs
Must Read
I ' m not going to discuss this or try to add to it, I ' m just going to ask you to read it.This is the McLuhan Lecture from Berlin, given by Cory Doctorow, on the subject of enshittificiation. We ' re all living through the enshittocene, a great enshittening, in
which the services that matter to us, that we rely on, are turning into
giant piles of shit.It ' s frustrating. It ' s demoralizing. It ' s even terrifying.I think that the enshittification framework goes a long way to
explaining it, moving us out of the mysterious realm of the ' great
forces of history, ' and into the material world of specific dec...
Source: Stayin' Alive - February 4, 2024 Category: American Health Source Type: blogs
Sunday Sermonette: Right to life?
The RSV labels Psalm 58 " A prayer for vengeance. " Since that is an addition by modern translators, I don ' t include it here, but at least they ' re frank about it. There ' s no indication of what, specifically, has provoked this fantasy of gory torture and murder, but the writer (not actually David) was really pissed about something. Note that according to the Bible, the literal, inerrant word of God, God wants the unborn babies of the unrighteous to be aborted (verse 8). I ' m not sure what the " pots " are in verse 9, and I can ' t find an explanation. Note in verse 1 that there are multiple Gods. Evidently the o...
Source: Stayin' Alive - February 4, 2024 Category: American Health Source Type: blogs
Medical care, medical costs
Thanks to
the Affordable Care Act, something like 90% of Americans have some form of
health insurance. Great news! That means we can all afford the medical services
we need and nobody has to go broke because they get sick or are injured in a
car crash or by somebody exercising their Second Amendment rights! Err, no. Sadly
it does not mean that. In the first place, for the 50% of people who get their
insurance through employment, it ’s costing them more and more for the premiums –
by three times the rate of inflation, since 1999. With that, plus
deductibles, copays, and payment denials by in...
Source: Stayin' Alive - February 2, 2024 Category: American Health Source Type: blogs
Too much fawning over Len Schaeffer?
By MATTHEW HOLT
There’s a lot of strum & dangst about the uptick in system utilization that has boosted hospital profits and hit Humana and United’s bottom line (But not so much Elevance’s). Kevin O’ Leary over at Health Tech Nerds brought this up today and I was reminded of this piece I wrote in 2006. And a big issue was, how much understanding and control do insurers have over the utilization in (and out of) their networks. So take a look at this piece and particularly, given the issues at the BUCAHs and at smaller players like Agilon, consider how much insurers actually know about spending...
Source: The Health Care Blog - February 1, 2024 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Health insurers Len Schaeffer Medicare Advantage Oldies Utilization Source Type: blogs
Wednesday Bible Study: Name that tune!
The introduction to several psalms refers to events in 1 Samuel when David is on the run from Saul, although the content is not really specific to the tale. In Psalm 56, "The Dove on Far-off Terebinths " is thought to be the name of the tune. (Terebinths are a kind of tree.) We ' ve seen a few of these instances where an existing composition is apparently given new lyrics. Oddly, however, 1 Samuel 21, in which David goes to Gad, does not actually say that the Philistine seized him. David was apparently afraid that KingAchish would do him ill, so he pretended to be insane, whereupon Achish expelled him. But there is no dire...
Source: Stayin' Alive - January 31, 2024 Category: American Health Source Type: blogs
Welcome to the nuthouse
Despite having his Precious Bodily Fluids depleted and polluted by the feminist succubus and the Bill Gates microchip vaccine, Travis Kelce turned in a Hall of Fame-worthy performance to lead the KC Chiefs to the Superb Owl. So, right on cue, MAGAland is in hysteria becausethe game was obviously rigged, presumably by an Italian satellite, Dominion Voting Systems, and Hugo Chavez.“Taylor Swift is an op,” Benny Johnson, a right-wing media
personality who boasts millions of followers across different social
media platforms, wrote on X. “It’s all fake. You’re being played.”“The Democrats’ Taylor Swift electio...
Source: Stayin' Alive - January 30, 2024 Category: American Health Source Type: blogs
Reforming new drug development
So what to do about the misalignment between incentives under the current drug patenting and licensing regime, and public health? (To summarize recent posts in a pistachio shell, the pharmaceutical industry is motivated solely by profit, the most profitable drugs are not necessarily the ones that contribute the most to population health, and the prices are too high for many people to afford in any case.) It is true that if there were an effective international regime to limit pharmaceutical prices, the investment in new R&D would be severely limited. As Thomas Pogge puts it (Pharmaceutical Patents and Economic
Inequali...
Source: Stayin' Alive - January 28, 2024 Category: American Health Source Type: blogs
Sunday Sermonette: David Kvetches
We have two short psalms and one long one today. " Mahalath " in Psalm 53 is probably a kind of stringed instrument, perhaps similar to a guitar. The singer believes that all of humanity is depraved. This seems to have been written at some time of ill fortune, but the context is not specified. Psalm 54 refers to an incident in 1 Samuel 23. David was hiding from Saul in the wilderness of Ziph, when the Ziphites (presumably some Ziphites, or their representatives) went to Saul and told him where David was to be found. Saul and his army went to capture David, but they were called away to respond to a Philistine att...
Source: Stayin' Alive - January 28, 2024 Category: American Health Source Type: blogs
Reflections on the Dumpster
Many sane people are baffled by the veneration of the Trump cultists for such a repulsive, worthless excuse for a human being. I ' m going to say what we aren ' t supposed to say. The answer is obvious: the characteristics of the Orange Shitpile that are most loathsome are exactly what they like about him. He gives not just permission, but affirmation, to the base impulses of people who aren ' t very smart and whose basic nature is selfishness, continual anger, and hatred.People who are ignorant, lack critical thinking skills, and whose minds are boxed in by prejudice and bigotry can ' t win arguments with facts and logic,...
Source: Stayin' Alive - January 27, 2024 Category: American Health Source Type: blogs
Calling out the bullshit
Conclusions and Relevance Results of this study indicated that research and development
investments did not explain the variation in list prices for the 60
drugs in this sample. Drug companies should make further data available
to support their claims that high drug prices are needed to recover
research and development investments, if they are to continue to use
this argument to justify high prices. In case you don ' t know much about statistics, this is as zero of a correlation as you will ever get. I mean no association at all, zip, zilch, nada. And I might add that the basic research to identify biol...
Source: Stayin' Alive - January 26, 2024 Category: American Health Source Type: blogs
