The Centers for Medicare & Medicaid Services (CMS) has finalized a rule that it says will address "the surge of improper enrollments" on Affordable Care Act (ACA) exchanges as well as take on wasteful spending. The agency said late Friday that there are likely millions of people who were improperly enrolled in ACA exchange plans. The CMS said 5 million people may have been enrolled improperly in ACA plans in 2024 alone, citing data from the Paragon Health Institute, a think tank promoting a free market approach to healthcare.
What Will Be Healthcare’s Next Big AI Use Case Following Ambient Scribes?
Over the past couple of years, ambient scribes have emerged as a clear breakout use case for AI in the healthcare field. Unlike other AI tools, ambient scribing has near-universal interest and adoption across health systems, pointed out Daniel Yang, Kaiser Permanente's vice president of AI and emerging technologies, during a recent interview.
Veterans Affairs Secretary Doug Collins attempted to assuage lawmakers’ concerns Tuesday over how the agency plans to deliver critical health tech services amid drastic cuts to its workforce. Appearing before the Senate Appropriations Military Construction, Veterans Affairs, and Related Agencies Subcommittee, Collins said the VA is full steam ahead on planned deployments of its oft-troubled electronic health record at additional facilities and is also pushing forward on the rollout of its External Provider Scheduling tool.
AHIP, the political advocacy and trade association of health insurance companies, announced in a press release on June 23 that health insurance plans made a series of commitments to streamline, simplify, and reduce prior authorization. “Building on health plans’ existing efforts, these new actions are focused on connecting patients more quickly to the care they need while minimizing administrative burdens on providers,” the news release stated.
Hospitals and health systems often struggle to establish a data-driven culture due to such challenges as fragmented data sources, outdated infrastructure, the complexity of healthcare regulations, and the need for significant investment in analytics capabilities. However, for healthcare organizations that overcome the barriers to create a data-driven culture, the potential benefits are immense: Faster, better, more proactive decision-making, empowered staff and clinicians, and, ultimately, stronger financial and clinical operations.
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