The new bipartisan House bill to stop surprise medical bills, explained

Congress is ramping up its push to stop surprise medical bills.

Reps. Frank Pallone (D-NJ) and Greg Walden (R-OR), the top Democrat and Republican on the House Energy and Commerce Committee, have jointly released a draft bill that would prevent patients from facing unexpected charges after they go to the emergency room or receive other non-emergency medical care.

The draft legislation, shared exclusively with Vox, is the most robust proposal yet as lawmakers from both parties and President Donald Trump say they want to end surprise billing. The plan would prohibit surprise charges not only for emergency care when a patient ends up at a hospital that is out of their insurance plan’s network, but also for non-emergency care when the facility might be in network but certain providers are not.

The full Vox article can be viewed at this link.  

Where the Board Room Meets the Exam Room: Bringing Business & Tech Leaders to Healthcare's Frontline

To be successful, entrepreneurs have to envision health care from a much broader perspective that takes into consideration the experiences of the care providers who interact and learn from their patients every day. Indeed, the key to innovation in health care lies in imparting caregivers’ human-centered attitudes, values and experiences to technologists and business leaders. But short of sending half of Silicon Valley to medical school, how do we do that? I recently encountered a few educational models that point the way.

The full Forbes article can be viewed at this link. 

Addressing Medication Costs During Primary Care Visits: A Before–After Study of Team-Based Training

A single team training to screen and address patients' medication cost concerns improved cost-of-medication (COM) discussions over the short term. Further research is needed to assess sustained effects and impact on patient costs and medication adherence and to determine whether more intensive, scalable interventions are needed.

The full article can be downloaded below.  

How Conversational AI Could Remake Health Care

One of the most pressing problems the United States faces is a shortage of access to health care. Some California politicians are trying to fix this with legislation that would improve access. While many are looking to policy to fix the problem, they should not overlook the role that emerging technologies can play in both managing health care and treating common conditions and diseases.

One of the places this is happening is the personal health care market, which includes family physicians and urgent care clinics, among other facilities. The adoption of "conversational artificial intelligence (AI)" by health care providers is part of a larger overall trend that will see the AI health care market rapidly expand in the coming years. Accenture predicts these changes could save the health care industry $150 billion a year by 2026.

Conversational AI offers a natural and intuitive method of communicating with customers. Traditional voice recognition systems are static. Customers need to navigate multiple menus and options and usually end up pressing zero for an agent. A conversational AI system starts with a question and then routes the customer to the right answer or solution, eliminating the wait and frustration. It's almost no different than talking to an empathetic person.

From faster claims to better management of chronic conditions, conversational AI could reinvent the global standard of health care. It could also help the industry save money and resources by ensuring that visits to emergency departments are only for severe or life-threatening conditions. 

The full Forbes article can be viewed at this link.  

Digital assistant uses AI to ease medical documentation at Sutter

Sutter Health is pilot testing a voice-enabled digital assistant that makes use of artificial intelligence to see if it increases clinician efficiency.

The Sacramento, Calif.-based delivery system is testing the device with a group of doctors in Northern California. The device uses a combination of voice commands from physicians and the context in which they are operating to create a clinically accurate note that is pushed to an electronic health record.

The full Health Data Management article can be viewed at this link.  

HHS To Implement Pay-For-Performance Models For Primary Care Practices Serving Medicare

Two weeks ago, the Department of Human and Health Services (HHS) unveiledthe "Primary Cares Initiative," a program that aims to "reduce administrative burdens" and enable primary care physicians to earn "performance-based payments" if they deliver care to Medicare patients that meets certain targets and decreases downstream healthcare costs.

CMS has posted a request for applications for the first cohort of primary care practices. The program is intended to go into effect January 2020 and continue for five years.

It is hoped that if the Primary Cares Initiative is successful in Medicare, state Medicaid programs and commercial payers will follow suit. The ultimate purpose of the initiative, according to the Director of HHS, Alex Azar, is to move primary care from a fee-for-service to a value-based system, predicated on paying for healthcare outcomes rather than numbers of procedures.

The full Forbes article can be viewed at this link.  

AI In Health Care Is Not About Replacing Humans

When a disruptive technology makes its presence felt in a discrete domain like health care, it’s bound to attract attention. The impact of artificial intelligence (AI) and its application through machine learning (ML) algorithms is already evident in health care. Funding for companies that provide AI-based health care solutions has especially witnessed a significant rise, surpassing $400 million in 2017 and breaking investment records. AI and machine learning are set to expand, and health care is poised to witness an unprecedented explosion of AI use cases.

The full Forbes article can be viewed at this link.  

“Am I a bad person?” Why one mom didn’t take her kid to the ER — even after poison control said to.

Sky-high medical bills shape patients’ lives. Not only do the bills put patients in overwhelming debt, but they also affect the health care decisions patients make.

A common refrain around debates about reforming the health care system is the idea of rationing. But rationing is already at work in the United States. There are those who can afford the care they and their families need, and those who can’t — because they worry about going broke from things like a single emergency room trip.

The full Vox article can be viewed at this link.  

Nuclear Medicine or Nuclear Weapons: The Digital Determinants of Health

It is increasingly possible for the aggregators of our data to record and analyse the way we; vote, shop, eat, move, communicate, and even the way we breath. Moreover, it is increasingly possible for the aggregators of our data to use it, and the digital communication channels they have into our senses to influence the way we vote, shop, eat, move, communicate and the way we receive healthcare. Artificial intelligence promises a step change in the speed at which such automation can happen.

As every element of our lives is increasingly digitised and digitisation increasingly influences every element of ours lives, the net impact of ‘digital’ on human health and the things that drive it, the digital determinants of health, are almost impossible to elucidate. But given their omnipotence, that shouldn't stop us trying. It is perhaps one of the most important considerations for the health and wellbeing of current and future generations.

The full Forbes article can be viewed at this link.  

Assessment of Screening, Brief Intervention, and Referral to Treatment Training to Interprofessional Health-Care Students

Substance abuse and addiction are responsible for an assortment of health and financial concerns in the United States. Tools to identify and assist at-risk persons before they develop a substance use disorder are necessary. Screening, brief intervention, and referral to treatment (SBIRT) can be utilized by health-care professionals to identify those at risk to minimize health-related complications and the potential of developing a substance use disorder. The primary objective of this study was to provide educational training sessions on SBIRT to health-care students utilizing interprofessional education activities and assess perceptions of the training sessions and activities with regard to confidence to utilize SBIRT in at-risk patients and overall student satisfaction with SBIRT instruction. The research protocol enrolled students of pharmacy, nursing, medicine, behavioral health, and physician assistant studies who received interprofessional SBIRT training. Students completed an anonymous posttraining online survey, measuring student perceptions of knowledge gained and confidence to utilize training. A total of 303 students completed the SBIRT training. Approximately 70% of students were satisfied with the training materials, instruction, quality, and experience. After training, 78% were confident that they could perform screening for substance abuse, conduct a brief intervention (80%), and when to refer to treatment (71%). A total 73% of students reported that the asynchronous online-based activity was extremely effective in increasing knowledge of the roles and responsibilities of other disciplines and providing opportunities to interact with students from other health professions. Interprofessional education-trained students from multiple health-care disciplines feel comfortable performing SBIRT to identify persons at risk for substance misuse in practice.

The full article can be downloaded below.