Qasim Butt, MD

The Association of Healthcare Value Analysis Professionals (AHVAP) celebrates Elizabeth Eisenberg, MSN, RN, CVAHP from Scripps Health for commitment to excellence in the specialty of healthcare value analysis! Liz has signified this commitment by signing the official Association of Healthcare Value Analysis Professionals (AHVAP) healthcare value analysis pledge. To learn more about the Association of Healthcare Value Analysis Professionals (AHVAP) Commitment pledge: https://lnkd.in/gqEWPBue. #AHVAP #valuebasedcare #excellenceincare #valueanalysis

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Here’s your recap of last week’s health IT news 🗞️ 👇 🖊️ AI Ambient Scribes • CHRISTUS Health + Abridge: The 15,000 provider Texas health system adopted the ambient scribe enterprise-wide.    • Tampa General Hospital + Nuance Communications DAX Copilot: Over 500 providers at the health system will begin utilizing the AI ambient scribe.    • Texas Oncology + DeepScribe: The statewide oncology practice adopted the AI ambient medical scribe. (ed. note: scribes continue to be hot!) ☎️ AI Contact Center • Clearstep: The AI conversational chat vendor launched a new feature allowing patients to self-schedule specialist visits. 📊 Data & Analytics • InterSystems + CLEAR: The cloud-based patient data service is integrating the identity technology to expedite access to patient records.    • WakeMed + Bamboo Health: The health system is adopting the data interoperability and encounter notification service. 🥼 Clinical Decision Support • University Hospitals + Aidoc: The Cleveland-based health system is implementing the AI clinical decision support platform across 13 of its hospitals and additional outpatient locations. 🧑‍💻 Virtual and At-Home Care • University of South Carolina School of Medicine + Rimidi: The hospital group and an affiliated multispecialty clinic are adopting the remote patient monitoring platform to reduce complications from postpartum hypertension.    • Mount Sinai Health System + HealthSnap: The medical center announced a new remote patient monitoring and chronic care management program in partnership with the virtual care management platform.    • Wheel: The telehealth company released a new AI-driven virtual care platform designed to enhance the patient experience and offer resources to help partners scale their virtual care services. 💬 Patient Engagement • CipherHealth: The patient engagement solution focused on patient rounding released a new AI summary tool.    • DexCare: The care orchestration platform completed a $75M series C funding round 🩼 Durable Medical Equipment • Better Health: The medical device and peer support network completed a $14M funding round. 🧠 Food for Thought: • Silicon Valley Bank released an interesting report on the state of investment in AI in healthcare, including stats on AI usage at healthcare organizations and the impact of leveraging AI on startup valuation. https://lnkd.in/em7AfivT    • The journal Critical Care Medicine published an editorial on an “in clinico” evaluation of a machine learning-based early warning system to predict in-hospital deterioration. We found it to be an interesting look at the actual impact of a model’s deployment on care processes and patient outcomes in a critical care setting. https://lnkd.in/eQhZbVKu

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During the recent AMA Annual Meeting, Beau Raymond, MD MMM FACP, Chief Medical Officer of Ochsner Health Network, shared compelling data on the impact of Ochsner Connected Health's Digital Medicine program for managing cardiometabolic diseases. His presentation highlighted the strategic use of digital tools to enhance patient outcomes and reduce overall healthcare costs. Dr. Raymond detailed how the program's success is underscored by its impressive impact on healthcare costs and member outcomes. Annually, enrolled members experience an average savings of $2,200 per person. Within just six months, four out of five members achieve hypertension and diabetes control, including a reduction in emergency department visits and hospital admissions. Leveraging data from connected Bluetooth devices and medication management from licensed clinicians, the program’s data-driven patient management extends beyond mere monitoring, embodying a transformative shift in cardiometabolic healthcare delivery.   We invite you to learn more about our innovative program: - Read the Full AMA Article: https://lnkd.in/gVjmxkDa - Discover how Ochsner's solutions can be part of your health strategy: https://ochsner.cc/4c0BvdZ #OchsnerConnectedHealth #DigitalHealth #ValueBasedCare #HealthcareInnovation #CardiometabolicHealth #Type2Diabetes #Obesity #Hypertension #GLP1

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Great conversation here between my colleague Blake Watts and our friends over at Leader's Edge Magazine! Blake discusses point solution fatigue, the importance of investing in health tech, and what makes Ochsner Connected Health a unique player in how we approach chronic disease management with employers nationwide. #HealthTech #EmployeeWellness #ChronicDiseaseManagement #DigitalHealth #ValueBasedCare #Diabetes #Hypertension #GLP1 #Obesity

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Walmart joins so many others in quickly entering and leaving or scaling back in healthcare after ambitious plans to scale. This morning, Walmart said it will close all 51 of its health-care clinics, as well as shut down their telehealth virtual care services. This is right after an announcement in March that they wanted to double the size of their clinical operations by opening up over 20 more locations this year and more next year. The reasons they cited? “Like others, the challenging reimbursement environment and escalating operating costs create a lack of profitability that make the care business unsustainable for us at this time.” As a physician, it’s been fascinating to watch over the past few years as so many non-medical companies try to get their bite of the huge percentage of the GDP that is healthcare. They pour money into trying to deliver healthcare at scale, ignoring the many concerns that hospital systems and physician private practices have been citing for years: declining reimbursements, shortages of clinicians, and expensive labor costs. Healthcare is broken, and those that are in it understand why. Patients need - and deserve - quality health care. This requires safe staffing practices, skilled clinicians who can feel good about what they do, and insurance companies that pay their bills. We can’t have a system where insurance companies can get away with record profits while finding more and more reasons not to pay for care and eroding away at the heart of healthcare. You cannot scale your way out of America’s healthcare problem. You actually need to fix the incentives, regulate insurance companies, pay clinicians appropriately, prioritize clinician well being and retention, and focus on the patient. The days of paying lip service to physicians leaving medicine and physician burnout are numbered. Supply and demand forces will necessitate real solutions that move the needle. Companies will come and go in the healthcare space when they realize how hard it is on the ground in healthcare these days. The question for patients and legislators is, who will be left to pick up the pieces if there’s no support for physicians, other healthcare workers, and hospital systems?  The percentage of clinicians leaving healthcare annually because they no longer recognize the heart of why they joined the profession is astounding, with over 1/4 of clinicians looking to leave within the next few years. Relying on the altruism of clinicians and the erosion of quality healthcare to support profits for corporations is just not a sustainable business model in healthcare - not to mention terrifying for public health. #HealthcareOnLinkedIn #PhysicianBurnout #PhysicianShortage #Walmart

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Here’s your recap of last week’s health IT news 🗞️ 👇 🤖 AI Clinician Assistant • Ochsner Health announced an enterprise-wide agreement with DeepScribe. 📋 Patient Administration • Weave is now integrated with eClinicalWorks.    • Phreesia is now available through Oracle Health's Marketplace.    • Samaritan Medical Center selected Loyal for managing provider listings. 💼 Provider and Practice Administration • MedStar Health is partnering with RLDatix on AI-based tools for analyzing patient safety events.    • Kontakt.io released a new solution to track hand washing and gamify compliance.    • Epic announced a new feature allowing users to securely release their healthcare information to apps of their choice. 🔁 RCM • Infinitus Systems, Inc. released a new instant benefits verification tool for commercial insurance patients seeking specialty medication.    • Providence expanded its implementation of Xsolis, designed to manage length of stay, mitigate denial risk, and ensure proper reimbursement.    • R1 RCM is being acquired by investment funds associated with TowerBrook Capital Partners L.P. and Clayton Dubilier & Rice. 📱 Patient Support and Communications • uMETHOD Health, Inc. is partnering with Linus Health on an integrated solution for earlier detection of cognitive impairment plus care planning. ⚙️ Clinical Operations • SimplePractice launched an ePrescribe platform following its acquisition of certain assets of Luminello, Inc.    • VitalHub Corp. is acquiring the clinical decision support vendor MedCurrent Corporation. 🧑‍💻 Virtual and At-Home Care • AvaSure has acquired the smart room technology vendor Ouva in an effort to expand its AI capabilities.    • VSee is partnering with Ava Robotics to give remote providers an inpatient presence. 🍎 VBC • Zing Health is leveraging Story Health for eligible members with the greatest risk of poor heart failure outcomes. 🧠 Food For Thought • A federal judge granted an injunction against PointClickCare for alleged information blocking tactics. Elion advisor Brendan Keeler shared a great post about some of the potential implications of this decision. https://lnkd.in/eb8F3FEr    • The The Cedars-Sinai Accelerator program announced its 10th class, and the theme was unequivocally AI with a strong bias toward clinical applications. We remain eager to see this shift from back-office use-cases toward patient- and provider-facing clinical solutions.    • UW Health and Epic announced the release of the National Roundtable on Artificial Intelligence in Healthcare’s recommendations to lawmakers. The TL;DR: Lawmakers should foster innovation across the patient experience (i.e. beyond traditional care settings, such as virtual, in-home, etc) and play a strong role in ensuring equitable access, minimal care disparities, and local validation.

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➡️ Whether you’ve determined now is the time for you to begin the process toward FACHE or you’re still deciding, the next stop on your journey is our FACHE Overview Webinar. This webinar is free for you to attend but it requires registration. Learn more and register here: https://bit.ly/4fVBYRC

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Health insurance companies Medicare Advantage plans subsidy and premium based EBITDA and Profits can only be guaranteed and expanded by taking from the physicians who manufacture preventive, medical, surgical and palliative outcomes with their patients and also taking from the hospitals in which clinical outcomes are manufactured and produced. #quadrupleaim, #medicare #medicareadvantage #healthcarecosts

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As healthcare leaders, we must continually evolve to ensure that every patient receives unbiased and empathetic care. A recent Forbes article highlights the need to address biases within our health systems. At Ochsner Health, we are dedicated to implementing strategies that combat biases and enhance patient safety and care quality. We foster an environment where patients actively participate in their treatment plans, respecting their preferences and values. This approach builds trust and promotes better health outcomes. Encouraging open dialogue and sharing experiences among our team members fosters a culture of continuous improvement and resilience. Ochsner Health embodies unbiased, empathetic care is not just an aspiration but our ongoing commitment and duty as healthcare leaders. Read more: https://lnkd.in/gDmmxkRT #Leadership

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Is Value-based care (VBC) the panacea that everyone now thinks it is? VBC is a healthcare delivery model in which providers, including hospitals and physicians, are paid based on patient health outcomes rather than the volume of services provided. Pros: 1. Improved Patient Outcomes: VBC incentivizes healthcare providers to focus on preventive care and managing chronic conditions, leading to better overall health outcomes for patients. 2. Cost Efficiency: By emphasizing preventive care and reducing unnecessary procedures, VBC can lower healthcare costs for both patients and the healthcare system as a whole. 3. Increased Patient Satisfaction: As healthcare providers are encouraged to spend more time on patient care and wellness, patients often report higher satisfaction with their care. 4. Holistic Care: Providers are motivated to address not only acute medical conditions but also long-term health through personalized care plans that consider a patient’s entire medical history and lifestyle. 5. Better Care Coordination: VBC encourages integrated care, where different providers collaborate to offer seamless and coordinated treatment across various specialties and stages of care. 6. Reduction in Hospital Readmissions: Providers are financially incentivized to reduce avoidable hospital readmissions by focusing on appropriate follow-up care and managing conditions proactively. Cons: 1. Implementation Challenges: Transitioning from a fee-for-service model to a value-based one can be complex and costly for healthcare systems, requiring new infrastructure, data collection methods, and staff training. 2. Risk for Providers: Providers take on financial risks if they fail to meet the agreed-upon health outcomes. This might deter some providers, particularly smaller practices, from adopting the model. 3. Data Requirements: Successful implementation of VBC requires sophisticated data analytics to track and measure outcomes, which can be difficult and expensive for smaller providers to implement. 4. Potential for Underservice: There’s a risk that some patients might receive less care than they need if providers become too focused on cutting costs and avoiding expensive treatments to meet value targets. 5. Variation in Patient Needs: Patients with complex or chronic conditions may be harder to treat under this model, and providers may be penalized for factors outside their control that affect patient outcomes. 6. Provider Burnout: The increased emphasis on performance metrics and patient outcomes might lead to added pressure and administrative work for healthcare providers, contributing to burnout.

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🌟 Whether you’ve determined now is the time for you to begin the process toward FACHE or you’re still deciding, the next stop on your journey is our FACHE Overview Webinar. This webinar is free for you to attend but it requires registration. Learn more and save your place here: https://bit.ly/3MkxxT8

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🔩 Q: What is a Bolt on healthcare benefit? ✅ A: Great question! Self-funded ERISA-governed plans may add on OPTIONAL services to provide more options for members and potentially save more time and money for both plans and members. We call these "bolt-on benefits" in the industry. Here are some examples, and even focused examples on #prescriptiondrugs and #pharmacy: 💊 -On site or near site clinics - that can provide quick appointments for members to get in to the doc or provider when their primary care providers are not available. At these clinics, members can obtain many drugs at these on site or near site clinics at a discount or even free to get them started and up to 100% of the drugs could be charged back to the plan. 💊 -Canadian drug importation programs - patients are allowed legally to personally import drugs with several stipulations (not biologicals, not controlled substances). I will reserve my personal opinions on these Canadian programs for now, but just know that they can be another option for members. 💊 -Cash pay on prescriptions and applying the cost to deductibles and OOPs - especially for the 1/3 of plans that are High Deductible Health Plans (HDHPs) - your plan, if you have a savvy consultant or broker, can set up a program to allow those with HDHPs to apply their receipts to their deductibles and out of pocket accumulators at the beginning of the plan year when patients have to pay out of pocket. You MUST ask your broker, however, if they can set up this option for your plan with the medical carrier, and show a clear pathway at open enrollment for members on where they may turn in their receipts to apply to their deductibles. 💉 Example: 1/1/25 is right around the corner and 70% of plans' accumulators will reset. With the Team Cuban Card, for example, people may pay cash of $748+ cash price with Yusimry, an adalimumab biosimilar, (https://lnkd.in/g5gJz_Mf) or they can purchase a more expensive option on their drug formulary. Why not take advantage of better cash pricing and rewarding the member for finding it and applying it to the deductible? 🛑 Now that the breach of fiduciary lawsuits have arrived, considering bolt on benefits is/are another critical component for plans to explore. If you offer your members options, you're demonstrating that one way your plan is meeting their fiduciary obligations. Maybe all these won't work for your plan.....but you miss 100% of the shots you never take. #pharmacybenefits #pharmacy

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Do you want to see who knows what we need to do and what is most important to fix health care? Listen to Sue Veer addressing this Committee. Hear from those who have a heart for serving most Americans most behind and are willing to sacrifice to address the next generation always ignored - and then we wonder why outcomes get worse. She was discussing 340B in about them most balanced and informative way possible. She noted how the CHC used 340 B "supports health care services that would otherwise be unavailable in many of the communities that we serve... the one that is near and dear to my heart are those early childhood services that are otherwise unfunded because we are building the health of the future generation" - Early Childhood Services - Sue Veer - More than a Hero - A leader for our nation and absolutely on target with her heart and her service and her testimony $600,000 margin lost and 0.6 FTE of labor to comply with 340 B - loss of nearly $700,000 in delivery capacity for those most in need! Did you hear this Congress, CMS, and others how you cut the lifeblood and distract the delivery team members time and time again over the past 40 years of design changes. Stop killing hospitals, practices, and delivery team members where most Americans are most behind. Start paying attention to Sue Veer and many others like her who can teach you how your designs fail and how they can work - for future generations. You do not fun health care where needed. You have forced a patchwork. Please don't kill the patches and pieces before you actually implement a plan for sufficient basic health access for 95% of the nation, not just 50 - 60%. Listen to the heart of health care delivery. Listen to those that you must fully fund who are the only ones that can be most and best for most Americans most behind.

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Starting April 1, 2025, Rural Health Clinics (RHCs) can include CPT Category II codes on Medicare claims. This advancement enhances quality reporting and aligns with value-based care initiatives, as these codes offer detailed insights into patient care. Previously, such submissions led to claim rejections; now, they aim to improve reporting accuracy without altering payment policies. Integrating these codes into the revenue cycle offers several benefits: 1. Accelerated Claims Processing: Detailed documentation reduces the need for additional payer audits, leading to quicker payments and less administrative burden. 2. Improved Quality Metrics: Tracking performance in areas like diabetes management aligns with programs such as Medicare’s Quality Payment Program, potentially resulting in higher reimbursements or bonuses. 3. Error Reduction: Precise coding minimizes errors in claims submissions, decreasing rework and payment delays. 4. Enhanced Negotiation Leverage: Demonstrating high-quality care through data enables better terms with private insurers, leading to higher payment rates or inclusion in premium networks. 5. Alignment with Value-Based Care: Participation in value-based contracts, where outcomes and quality metrics drive revenue, can unlock shared savings and incentive payments. While CPT Category II codes themselves are not reimbursable, their strategic use supports faster payments, fewer denials, and operational efficiency, positively impacting cash flow and the revenue cycle. #Medicare2025 #RuralHealthCare #CPTCodes #QualityReporting #HealthcareUpdates #ValueBasedCare #HealthTech #RHCUpdates #MedicalCoding #HealthPolicy #RevenueCycle #HealthcareInnovation #PatientCareQuality #HealthCareReform https://lnkd.in/etXFK3UG

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My next Signal takes a closer look at the latest antitrust probe into large dialysis companies and the shifting role of non-competes in kidney care. A recent POLITICO article provides helpful background around topics like NCAs in dialysis and impacts on the adoption of home dialysis technologies. This is an important discussion, so I'd love to hear from you. If you have something you'd like to share, whether it's an anecdote, comment or question for other readers, please leave a comment or send me a message. H/t to Tom Mueller for sharing the article last week. https://lnkd.in/e95a23JF

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