Satish Dave

The Czar is speaking TOMOROW on the new 2025 Medicare rules from Centers for Medicare & Medicaid Services!!! pretty much the biggest legal webinar in the Medicare vertical ever... still free. for now. Puja J. Amin Christopher Deatherage John Henson #tcpa #cms #aep #oe #Medicare #advantage #leadgen #tpmo #ptc #pewc #2025 #webinar #learn #deservetowin

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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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Let's keep hospice focused first and foremost on the PATIENT. After all, we only get one chance to do it right... "There are six primary trends that are influencing consolidation and professional practices: regulatory complexity. technology and integration, private equity ownership. demographics, economies of scale and consumer expectations,” Henderson said. “So many of these things that we see that are influencing health care consolidation need to be pointing toward the patient." #patientsfirst #hospicecare #youonlygetoneshot https://lnkd.in/gbbgV-YF

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Healthcare is changing at a rapid pace. Documentation based AI is evolving rapidly and is already changing the EHR space. A standardized process to incorporate these changes into practice is key. Learn more here and provide your comments and thoughts.

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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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Cost analysis in isolation lacks depth. Consider comparing costs - or cash shortfalls - from multiple angles: -Procedure codes -CPT codes -Payers -Aged A/R A record of CARCs and RARCs can be used to map shortfalls and denials, getting you closer to the root causes. This is what my team calls an RCM Health Check and I’m covering the concept in a webinar this Thursday. Join me here: https://lnkd.in/epuhRSn7 

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Listen Here: https://lnkd.in/gHmTQxfr This episode of Becker's Healthcare dives into the future of prostate surgery with Arun Menawat, Chairman and CEO of Profound Medical Inc.. We explore how Profound Medical's technology, including TULSA-PRO, fits into the growing landscape of minimally invasive and robotic surgeries. The discussion also examines the role of advanced diagnostic imaging in prostate disease and the benefits and challenges health systems face when adopting new surgical technologies. This episode is sponsored by Profound Medical Inc. (https://lnkd.in/gfRv7dQh). For more information about Becker's Healthcare, please contact Jessica Cole or Scott Becker. #podcast #healthcare #innovationinhealthcare

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Medicare Advantage plans leveraging AI tools in coding and audit workflows enhance accuracy, efficiency, and compliance. By embracing technology, plans improve data quality, ensuring confidence during risk adjustment audits. Moreover, continuous insights into members' health empower plans to drive high-quality outcomes. #MedicareAdvantage #AI #HealthcareTechnology

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AI is good and growing fast but we are still in the developmental stages. Companies need to be careful with the claims they make. Texas Strikes Settlement with Dallas AI Firm Over Misleading Healthcare Tech Claims 📢 Issue: The State of Texas, through its Attorney General, filed a petition for the approval and entry of an Assurance of Voluntary Compliance (AVC) with Pieces Technologies, Inc. The key issue involves whether Pieces Technologies, Inc. engaged in deceptive practices under the Texas Deceptive Trade Practices - Consumer Protection Act (DTPA) by making false or misleading representations about the accuracy of its artificial intelligence (AI) products used in healthcare. 📢 Rule: The Texas Deceptive Trade Practices Act (DTPA) prohibits false, misleading, or deceptive practices in the advertising and sale of goods or services (Tex. Bus. & Com. Code §§ 17.41-.63). Specifically, Section 17.47 allows the Consumer Protection Division of the Attorney General’s office to investigate and take action on violations. 📢 Application: Allegations by the State of Texas: Pieces Technologies developed and marketed AI products intended to assist healthcare providers in treating patients. It claimed its products had very low error rates (referred to as "hallucination rates") in creating outputs like clinical notes. The state alleged these claims were false or misleading, violating the DTPA, since the AI could produce incorrect or misleading outputs. Response by Pieces Technologies: The company denied any wrongdoing or liability, stating that its claims about the AI’s accuracy were accurate and did not violate any laws. Assurance of Voluntary Compliance: To settle the matter without prolonged litigation, Pieces Technologies agreed to a series of actions, including: Providing clear and conspicuous disclosures in all marketing materials regarding the accuracy and metrics of its AI products. Prohibiting misleading or unsubstantiated representations about the accuracy or testing of its AI products. Ensuring transparency with customers about the potential risks and limitations of its products. Complying with the AVC terms for five years and implementing internal processes to monitor compliance. 📢 Conclusion: Pieces Technologies agreed to settle the matter by entering into the AVC, which does not constitute an admission of liability. The company agreed to specific practices and disclosures to comply with Texas law, as outlined in the AVC, and the court’s approval was sought for the AVC. --------------- Sanjay Juneja, M.D. Douglas Flora, MD, LSSBB, FACCC Nixon Gwilt Law Sean Weiss Ronald Chapman II, Esq. LLM Michael Crocker Rebecca E. Gwilt David Penberthy, MD MBA FACCC VMG Health ECG Management Consultants Etyon HLTH Inc. Aashish Shah ------ https://lnkd.in/enduqyDe.

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This Thursday the Energy and Commerce Committee will hold a hearing on the Centers of Medicare and Medicaid Improvement (CMMI). Members of the Committee are expected to raise concerns and praise for the agencies' efforts to test and achieve savings in value-based payment models over the years. Since its inception in 2010, CMMI has tested many new payment models including bundled payments, multiple accountable care organization offerings, and the making care primary model. The agency continues to face challenges, such as finding ways to engage rural providers and solo or small physician specialty practices. Reps. Michelle Steel and Susie Lee and Sens. Markwayne Mullin, Kyrsten Sinema and Thom Tillis introduced the EASE Act (HR 7149 / S.4078) to encourage CMMI to create a new payment model for rural and underserved communities to reduce long wait times that many seniors and residents face in these communities when seeking care from a specialist. The bill was developed based on years of data collected and reviewed by OCHIN to help community health centers and rural hospitals improve care integration and create a new value-based payment model. While Congress looks for ways to improve outcomes and reduce costs; and medical schools continue to look for ways to grow the physician workforce, one pathway that would fill the needs of communities (especially rural areas) and prevent avoidable hospital admissions is the EASE Act which looks to utilize telehealth or e-consults to help our most vulnerable populations receive timely care

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A new Guidehouse Health analysis of a Healthcare Financial Management Association (HFMA) executive survey reveals payer challenges, prior authorization, workforce, and cybersecurity as top areas of revenue cycle stress. Leaders are investing in automation, AI, and outsourcing to improve performance. Learn more.

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CMS’s Enhancing Oncology Model, designed to improve patient outcomes and reduce costs, opened another round of applications in July 2024. Understand the potential benefits and financial implications of the model to determine whether participation would be beneficial for your organization and prepare for compliance and reporting requirements in this Moss Adams article by Georgia Green, MS, CHFP. #healthcare #CMS #valuebasedcare

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The #FTC has issued a final rule banning noncompetes nationwide, protecting the fundamental freedom of workers to change jobs. FTC’s final rule is supposed to generate over 8,500 new businesses each year, raise worker wages, lower health care costs, and boost innovation. This is going to change the entire landscape Existing noncompetes for senior executives - who represent less than 0.75% of workers - can remain in force under the FTC’s final rule, but employers are banned from entering into or attempting to enforce any new noncompetes, even if they involve senior executives. Employers will be required to provide notice to workers other than senior executives who are bound by an existing noncompete that they will not be enforcing any noncompetes. #employers #employees #executives #producers #brokers #consultants #workers #managers #sales

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What does the future hold for retail medicine and virtual care? Walmart is the latest to announce their health center closure. https://lnkd.in/geZpMTkS. This following Optum news, VillageMD closing in Nevada, Teladoc Health problems, etc. What comes next? This is another in a long line of examples that technology and even consumer willingness are not enough when the reimbursement environment does not support particular care models. Are we getting ready to lose all the lessons painfully learned during the pandemic? Or will new virtual care models emerge following this round of closures?

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Program Audit season is over. Join our webinar to hear all about what CMS is focusing on. If you haven’t done a mock audit now is a great time to do one and incorporate our lessons learned.

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