Ari Entin

What does calling my cable company have to do with Medicaid? I had to call a certain notorious cable/internet provider recently. The one with customer service so bad that it was skewered in a classic South Park episode. I blocked out an hour and braced for my inevitable PCOM aneurysm rupture. Shockingly, it was a breeze. The rep was friendly, and my issue vanished in minutes—a far cry from their usual 'dial-one-to-scream-into-the-void' reputation. So, what changed? Competition happened. A decade ago, our choices for cable and internet were as limited as the soda options in a health spa. Now, thanks to a buffet of streaming services—even including live local TV—the old cable giants had to step up their game or step aside. Turns out, competition is more effective than caffeine at improving service quality. Why can't Medicaid beneficiaries get the same treatment? Currently, most Medicaid coverage is through Managed Care Organizations (MCOs), where the state pays a fixed monthly rate per patient. This model should spur cost-efficiency, but it often just limits the scope of care. Low payments to doctors, restricted access to necessary services—who does that help? Could strict government regulations guarantee better service? Maybe, but FA Hayek (and a basic reading of history) prove that bureaucracy alone can't engineer excellence. And choice for Medicaid patients? Virtually non-existent. Many areas offer just one MCO. If you're dissatisfied, too bad—there's no alternative. It's like being stuck with dial-up in the era of fiber optics. Long wait times for basic procedures, no freedom to seek better coverage... It's eerily reminiscent of the old cable monopoly days. In the private sector, at least there's a semblance of choice: HMOs, PPOs, HSAs... But for Medicaid recipients? Sorry, the state chooses for you. Hope you like it. Our Medicaid system desperately needs a dose of competition. Isn't it time we offer Medicaid patients the luxury of choice that drives quality up and costs down? https://t.co/C7XE6CpIIP Joe Grogan Lisa Grabert Joanne Spetz Cheerag Upadhyaya, MD, MBA, MSc, FAANS, FACS Brian R. Gantwerker, MD, FAANS, FACS Sanjay Dhall Larry Bucshon, M.D.

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The Future Organization LLC has been accepted as a state-approved vendor for the California Department of Health Care Services (DHCS) Providing Access and Transforming Health (PATH) Technical Assistance (TA) Marketplace! The following categories of organizations can apply to receive DHCS PATH TA funding to engage The Future Organization at no direct cost, for customized consulting services across the domain of building data capacity, including data collection, management, sharing, and use: ·      County, city, and local government agencies, including public health departments ·      Providers (including, but not limited to, public hospitals and provider organizations) ·      Community-based organizations (CBO) ·      Other ECM and Community Supports providers ·      Correctional agencies and other justice-involved stakeholders ·      Medi-Cal Tribal and Designees of Indian Health Programs The PATH TA Marketplace also has a range of approved providers to serve a variety of organizational and service improvement needs across other domains.  If your organization belongs to one of the above categories and is in need of technical assistance or consultancy support, please visit the PATH TA Marketplace link below to learn more and get access to helpful tools and resources!

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According to this article in Modern Healthcare, discussing a report from the Center for Healthcare Quality and Payment Reform, we have 16 rural hospitals at risk of closing in Washington State, and another 8 in Oregon. It’s disheartening but not surprising when reimbursement rates don’t cover the cost to provide care and hospitals have been operating at a loss for much too long. Make no mistake, it is an issue of health equity when our neighbors in rural and underserved communities face hospital closure and risk further losing access to care.  #healthequity #healthcare #healthcareaccess https://lnkd.in/gHr4Qz-j

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If you are newer to Oregon Health Tech, wondering about Epic and data sharing with external entities, OHLC is putting on a primer for you on EpicCare Link. Take a moment to learn and listen, and make connections so we can further interoperability as a community ❤️ (And no, Link is not perfect, but it’s a foundational tool anyone in healthcare Tech should understand as a building block for what is possible as current state 🧠 🤩)

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AI’s Impact on CDI A recent ACDIS Survey of ACDIS members gauging impact of AI on CDI processes and the CDI profession revealed some interesting points and sentiments towards AI. The most common impacts from the implementation of CDI technology are increases in remote work and in productivity (cited by 67% each), followed by identifying “low-hanging fruit” queries (65%) and improving documentation issues with high-volume DRG groups (54%). Additional responses appear in Table 4 below. Remote work is not conducive to effectively providing sustainable measurable physician documentation educational training. One-on-One training or small group training is most effective in ultimately changing overall physician behavioral patterns of documentation. Often, the best form of training is small bit size nuggets provided in a quick conversation specific to a case on the floor. Productivity is not a valid and reliable measure of CDI performance. The mere fact that the CDIS reviewed a record does not necessarily equate to achieved improvement/integrity of the record. Identifying low hanging fruit diagnoses through queries implies CDI has room for improvement in physician documentation education through reinforcement that improves physician's muscle memory of better documentation practices. Electronic querying serves to mechanize the query process and is no substitute for physician documentation training and knowledge sharing. Physicians do not want more queries, they prefer to document right the first time versus more repetitive transactional reactive queries. AI definitely can assist and serve as an effective tool in CDI activity. However, it must be considered as a tool and not a crutch. There simply is no substitute for good old fashioned CDI boots on the ground, helping physicians achieve clinical documentation excellence through documentation training with reinforcement and guidance. AI is the panacea for improving documentation. #AI, #documentationimprovment, #notapanacea

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I'm concerned about the potential impact of proposed benefit reductions on Portland's city workers and first responders. Union health insurance is vital for ensuring the well-being and financial security of members, and any cuts could effectively erode their hard-earned benefits. Transparency and fair negotiation processes are essential in safeguarding member's interests, especially amidst tight budgets and rising costs. #UHCLaborandTrust #BelieveinBetter #LaborUnions #HealthInsurance #HealthBenefits

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September is National Suicide Prevention Month. Thank you Katrina Domingo, PsyD for nominating subject matter expert, Terra Morais, Psy.D., provide insightful tips for suicide prevention. Dr. Morais has worked for Kaiser Permanente for 9 years, and has been manager of its Psychiatric Consultation Service for 2 years. She has specialized training in the treatment of psychiatric emergencies in children and teenagers. We all have times when we feel sad or overwhelmed. For some people, these feelings can become so strong that they have thoughts of ending their life. Suicide is a leading cause of death in the United States and has been on the rise across all groups for years, but we can take steps to help prevent it.   SELF If you are having serious thoughts that you or your loved ones would be better off if you were dead, the most important action you can take is getting immediate help. You can call or text 988 to talk to someone who knows how to keep you safe. If you notice yourself having these thoughts occasionally, or find yourself feeling hopeless, here are some steps to help prevent those thoughts from getting worse: 1. Tell someone you trust how you are feeling. This can be scary, but it the people who care about us want to help us feel better and can be devastated by the thought that they could have helped if only they had known how their loved one was feeling. 2. Prioritize your sleep and reducing stress in any way you can. Lack of sleep contributes to problems with mood, thinking, and emotional regulation. 3. Make a plan to do something enjoyable with a loved one and ask them to help you stick to it. Research has shown that social connections and responsibilities are highly protective factors in preventing suicide deaths. OTHERS Here are some warning signs that someone may be having thoughts of suicide: https://lnkd.in/dyz2BZsd If you notice worrying changes in someone you know, here are a few ways to help: 1. Ask them if they have been feeling like hurting or killing themselves. Sometimes people worry that asking will “put the idea in someone’s head,” but in fact people struggling with thoughts of suicide are usually relieved that they can talk about it. 2. When someone tells you about their thoughts of suicide, listen without judgment or argument and ask if they want assistance reaching out for help. You can call or text 988 with them or make sure they have the number.   RESOURCES The National Suicide Prevention Lifeline (24/7 toll-free suicide prevention service): Dial 988, https://988lifeline.org/   Suicide Prevention Hotline in Spanish: 1-888-628-9454, https://988lifeline.org/   LGBT Youth Suicide Hotline: 1-866-488-7386, or text START to 678-678, https://lnkd.in/d656hGQy   The Crisis Text Line: Text "HOME" to 741741 for free, 24/7 crisis support #suicideprevention #suicidepreventionawarenessmonth #TPMG #DSA #health #wellness #leadership #tips #support

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Join the conversation! Our team is facilitating the strategy task force of a hospital client in Washington State this week. We're analyzing surveys, focus groups, market, and organizational data to develop a strategic plan framework for the next three years. What are your favorite and least favorite strategic working session activities? Do you hate ice breakers? Love SWOT analysis? Share your thoughts! #strategicplanning #healthcare #hospital #WashingtonStateHospitals #taskforce #dataanalysis

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This paper addresses real-world implementation challenges and benefits of Federated Learning in radiology, proposing a comprehensive guide for deploying FL in clinical practice. 1️⃣ The study highlights FL's ability to train collaborative DL models without sharing sensitive data, making it suitable for regulatory compliance (e.g., GDPR, HIPAA) in medical imaging. 2️⃣ A practical FL framework was implemented within the German RACOON initiative, involving six university hospitals, to train DL models for lung pathology segmentation across diverse datasets. 3️⃣ Major challenges identified include organizational hurdles, legal complexities, infrastructure limitations, data heterogeneity, and evaluation difficulties in real-world FL settings. 4️⃣ The authors propose solutions such as standardizing data specifications, incentivizing site participation, deploying offline-installable FL platforms, and using automated data validation tools. 5️⃣ Experimental results show that FL models, particularly specialized ones, consistently outperform local and ensemble approaches in segmentation tasks, proving FL's robustness and utility despite high heterogeneity. 6️⃣ The proposed guide categorizes FL challenges into "practical hurdles" (solvable with technical/legal measures) and "inherent difficulties" (requiring acknowledgment in FL design). 7️⃣ The study emphasizes the scalability and clinical impact of FL for advancing radiological research while providing detailed guidance to streamline future FL initiatives. ✍🏻 Markus Bujotzek, Ünal Akünal, Stefan Denner, Peter Neher, Maximilian Z., Eric Frodl, Astha Jaiswal, Moon Kim, Nicolai Krekiehn, Manuel Nickel, Richard Ruppel, Marcus Both, Felix Dollinger, PD Dr. med. Marcel Opitz, Thorsten Persigehl, Jens Kleesiek, Tobias Penzkofer, Klaus Maier-Hein, Andreas Bucher, Rickmer Braren. Real-world federated learning in radiology: hurdles to overcome and benefits to gain. Journal of the American Medical Informatics Association. 2025. DOI: 10.1093/jamia/ocae259

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The Health Industry Cybersecurity Strategic Plan (HIC-SP) is a call to action for organizations throughout the healthcare ecosystem to implement foundational cybersecurity programs that address the operational, technological, and governance challenges posed by significant healthcare industry trends over the next five years.

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The integration of data across government programs is pivotal in addressing the social drivers of health. California Department of Health Care Services and California Cradle-to-Career Data System are collaborating on an innovative endeavor to connect data to improve outcomes for all Californians. This interconnectedness paints a holistic picture, allowing for the identification of patterns and trends that may not be visible when data is siloed. Learn more on how cross-sector collaboration can bridge sectors and create a seamless information ecosystem. https://lnkd.in/giEJJfuB

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Epic Systems’ recent move to back the TEFCA medical records exchange is interesting. On the surface, it’s all about creating a seamless flow of patient data across hospitals, QHINs, and all relevant stakeholders. But let’s be real—data is the oil of the new economy, and interoperability is the pipeline that delivers this precious resource to all the right stakeholders. By aligning with TEFCA, Epic might just be positioning itself as the refinery. All in all, this is a welcoming move by Epic Systems—especially if it really is as straightforward as they make it sound. But given the lack of details, one has to wonder if there are any hidden catches. After all, when it comes to something as valuable as healthcare data, it’s wise to look out for the fine print. Let’s hope this is genuinely about improving patient care. https://lnkd.in/gDdDCcmj

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Strategic planning overcomes hurdles in the future by considering variable scenarios to eliminate the "we can't get there from here". #impactful #StrategicPlanning #BusinessResilience

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How can Medi-Cal improve its transportation benefit? In 2020, the California Health Care Foundation released a study of the Medicaid benefit, calling out several ways the state and managed care plans could make it better for members, providers, and California. Have those recommendations been implemented? Read our latest blog to find out. https://hubs.li/Q02B9_780

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Ketul J. Patel Thanks for raising awareness of the massive care disparities between rural and urban healthcare systems.  Having practiced in rural Washington for the past 15 years, I’ve seen a growing disdain for innovation and an intolerance of risk by our administration.  Rural healthcare systems can’t waste time trying to be the next Virginia Mason.  It’s just not a level playing field and the large system playbook won’t work for us.  We need leadership that values a different pathway, tailored to the communities we serve.  If we don’t reframe our approach, we will continue to see the collapse of rural healthcare.  I like to invoke Moneyball to better frame this.  Here in Wenatchee, we are the Oakland A’s to Virginia Mason’s New York Yankees.   If we are going to stay alive, then we need to play the game with more grit, strategy and innovation.  This is our reality.  If we accept it, then we can better serve our communities and create a winning rural healthcare ecosystem.

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Very grateful for The Doctors Company leadership and expertise and for continually supporting the Ventura County Medical Association. Thank you for this insightful update! Artificial intelligence (AI) is reshaping healthcare, but with this transformation comes critical questions around data, ethics, patient consent, and liability. This TDC Group article breaks down the four phases of AI development in healthcare and the legal and ethical considerations at each stage. Learn how these challenges can be addressed to utilize AI's full potential while ensuring patient safety and ethical integrity: https://lnkd.in/gbi7Vm-b #patientcare #physicianresources #medicalinnovation #riskmanagement #medicalpracticemanagement #cmadocs #venturacountymedicalassociation

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