Wed.Dec 13, 2023

article thumbnail

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.

article thumbnail

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.

Medicare 321
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

'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.

article thumbnail

Google reveals new generative AI models for healthcare

Health Care Dive

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

article thumbnail

From Diagnosis to Delivery: How AI is Revolutionizing the Patient Experience

Speaker: Simran Kaur, Founder & CEO at Tattva Health Inc.

The healthcare landscape is being revolutionized by AI and cutting-edge digital technologies, reshaping how patients receive care and interact with providers. In this webinar led by Simran Kaur, we will explore how AI-driven solutions are enhancing patient communication, improving care quality, and empowering preventive and predictive medicine. You'll also learn how AI is streamlining healthcare processes, helping providers offer more efficient, personalized care and enabling faster, data-driven

article thumbnail

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.

article thumbnail

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.

More Trending

article thumbnail

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.

article thumbnail

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.

304
304
article thumbnail

When the Law of Scientific Evidence Collides with Medical Practice

Bill Of Health

By Barbara Pfeffer Billauer Approaches to resolving scientific evidentiary issues continue to diverge throughout the country. [1] A prominent recent example includes the rejection of the medical diagnosis of Shaken Baby Syndrome (SBS) to reflect disparate views in the scientific, medical, and legal communities. Under guise of making a scientific evidentiary ruling, a New Jersey court has just dismembered the medical diagnosis of SBS, with the judge disavowing the condition’s validity.

article thumbnail

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.

Medicaid 287
article thumbnail

How to Make The Best Benefits Decisions for 2025's Workforce: An HR and Total Rewards Guide

Speaker: Kaitlin Ruby Carroll

Retaining top talent in 2025 means rethinking benefits. In a competitive job market, fertility benefits are more than just offerings - they are a commitment to your team’s well-being. Gain critical insights into the latest fertility benefits strategies that can help position your organization as an industry leader. Our expert will explore the unique advantages and challenges of each model, share success stories from top organizations, and offer practical strategies to make benefits decisions tha

article thumbnail

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%.

Medicaid 116
article thumbnail

AMA: 73% of insurer markets were highly concentrated last year

Fierce Healthcare

Most insurer markets are highly concentrated, including many regions where a single payer dominates at least half of the market share, according to a new analysis from the American Medical Associat | Most insurer markets are highly concentrated, including many regions where a single payer dominates at least half of the market share, according to a new analysis from the American Medical Association.

170
170
article thumbnail

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.

110
110
article thumbnail

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.

article thumbnail

Why Every Small Business Needs an HCM Solution: A Comprehensive Guide

Managing HR tasks like payroll, compliance, and employee data can overwhelm small businesses. That’s where a Human Capital Management (HCM) solution comes in. Our eBook, Why Every Small Business Needs an HCM Solution: A Comprehensive Guide , shows how an HCM system automates tedious processes, ensuring your business stays compliant and efficient. You’ll learn how to simplify payroll, eliminate costly errors, and empower your employees with self-service tools.

article thumbnail

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.

article thumbnail

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.

Home Care 130
article thumbnail

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.

article thumbnail

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.

Home Care 111
article thumbnail

Best Practices to Streamline Compensation Management: A Foundation for Growth

Speaker: Joe Sharpe and James Carlson

Payroll optimization can be one of the most time-consuming and complex factors of small business management. Yet, organizations that crack the code on streamlining employee compensation often discover innovative avenues for growth. With the right strategies in place, outsourcing and streamlining payroll processes can result in substantial time and resource savings.

article thumbnail

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.

article thumbnail

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.

article thumbnail

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.

article thumbnail

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.

95
article thumbnail

How To Empower Your Workforce With Modern Fertility Benefits

Speaker: Andrea Wuchiski

In an era where a workforce spans multiple generations, HR managers and Total Rewards leaders face the unique challenge of designing benefits packages that cater to diverse employee needs. This session will delve into how comprehensive fertility benefits can bridge generational gaps, support employees’ health, and enhance workplace satisfaction. Join us for an insightful session that highlights the strategic importance of fertility benefits in today’s competitive job market.

article thumbnail

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

article thumbnail

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.

97
article thumbnail

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.

article thumbnail

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.

article thumbnail

Enhance Healthcare Efficiency With Top Payroll & HCM Services

Running a healthcare facility requires precision and care, not just for patients but also for your staff. Our guide, "A Buyer’s Guide to Payroll & HCM Services," helps healthcare providers choose the best provider. Efficient payroll management ensures timely, accurate payments, critical for maintaining staff morale and trust. Compliance support helps navigate complex healthcare regulations and avoid costly fines.

article thumbnail

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.

article thumbnail

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.

article thumbnail

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.

article thumbnail

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.

61
article thumbnail

Creating a Company Culture of Care: Integrating Mental Health, Wellbeing, and DEI in Benefits

Speaker: Sean Raible

Picture a workplace where physiological safety is not just an aim but a reality, driven by thoughtful employee benefits that prioritize mental health, wellbeing, and DEI. 🤔 ✨ Achieving this vision requires more than just occasional training sessions and employee assistance programs. Moving beyond the basics, this vision calls for a holistic approach that integrates these elements into your company culture as well as your HR and benefits strategy.