Jonathan Perlin

Community Health Centers provide care for populations with high needs and often limited other options. Entering into, and succeeding in, value based contracts can be a daunting task, especially when each contract has different performance terms and KPIs, and each payer provides different levels and formats of data. Creating a single source of analytics and providing insights that are relevant across the different programs is one way we are helping these organizations.

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The amended "Improving Seniors' Timely Access to Care Act of 2024" (S. 4532/H.R. 8702) aims to 1) reduce the administrative burden placed on physicians by streamlining and standardizing electronic prior authorization processes within the Medicare Advantage program and 2) limit unnecessary delays in patient care by mandating greater transparency and oversight of utilization management techniques used by health insurers – without increasing the federal deficit. Let your voice be heard! Contact your Representative and Senators and ask them to cosponsor the Improving Seniors' Timely Access to Care Act of 2024 today! https://bit.ly/3VIrKfQ #FixPriorAuth

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The top U.S. hospitals leading in AI innovation are Mayo Clinic, Intermountain Health, Cleveland Clinic, Kaiser Permanente, Mount Sinai, and Johns Hopkins. Congratulations to Kaiser for being in the top 5! In relevance to sepsis and healthcare quality: - Predictive Algorithms: AI algorithms can predict simple sepsis before organ dysfunction (before they "look septic"), enabling timely interventions to reduce morbidity and mortality. [commentary: several of the "predictive algorithms" on the market are early detection because they require signs of end-organ injury to alert - this is not "prediction"] - Early Detection Tools: AI [cognitive] sepsis models have potential if they integrate with reliable biomarkers. Reasons to read the article: - Stay Informed: Learn how hospitals implement AI to enhance patient care. - AI Applications: Discover AI use in clinical documentation, surgical tools, and wound care. - Benchmarking: Compare your organization's AI readiness with that of industry leaders. I intentionally withheld specific commentary and suggestions from the post. Please let me know if you want to discuss AI and Sepsis.

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Download the summit outcomes report #digitalhealth

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https://lnkd.in/gvSqxCbQ This fall will mark 14 years since CMMI launched the Comprehensive Primary Care Initiative, followed by CPC+ and the Primary Care First. Now Make Care Primary (MCP) is launching. Its predecessors showed quality improvement but not conclusive savings. Will MCP prove to be different? Does lower cost necessarily follow improved quality? Scott Conard, MD #primarycare #healtheconomics #quality

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Missed our webinar about the hype surrounding AI and outpatient infusion coding? Watch this snippet from the event to see how having an automated solution can simplify your coding so that you aren't leaving revenue on the table.

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The potential for AI in healthcare seems to be 'limitless' but it's not a silver bullet, we have to keep humanity at its center. Honored to talk to Chief Healthcare Executive on this topic! #GenerativeAI #AI #HealthcareInnovation

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It seems that the government is serious about finally realizing the vision of true health data interoperability. The attached Point-of-Care Partners blog post describes the recently released HTI-2 Proposed Rule which is another step in the fruition of that vision. Point-of-Care Partners can help your healthcare organization stay ahead of the waves of regulatory activity around interoperability. Let me know if you are interested in learning how.

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Shifting the financial model alone is not sufficient for the transition - the care delivery, workforce, and many other pieces of the ecosystem with which PCPs interact also need to adjust accordingly. Funding to allow for the startup costs of transformation must be made available. A comprehensive analysis from The Commonwealth Fund: To encourage participation, practitioners say upfront payments, investment in the primary care workforce, and less emphasis on simplistic quality measures are needed, as well as more support for practices to provide accessible, comprehensive care. #primarycare #integratedcare #teambasedcare #healthcare #healthcareonlinkedin

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Nataliya Becker just led an engaging session on fear-free accountability in healthcare administration, marking the inspiring closing of The Healthcare Administration Conference 2024! Here is a quick recap of Nataliya's session: 🔍 Nataliya highlighted the challenge of traditional definitions of accountability where there is room for a more constructive approach. 💪 The audience also explored with Nataliya how empowerment and accountability can coexist harmoniously to motivate individuals. 💬 Lastly, Nataliya introduced us to effective accountability conversation techniques for impactful check-ins. #Accountability #LeadershipDevelopment #HealthcareAdministration

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On #NationalRuralHealthDay, #AHRQ is proud to highlight the Healthcare Extension Service, is designed to enhance healthcare delivery through improvements in healthcare policy, payment systems, and clinical practice, and to reduce healthcare disparities especially among people who receive Medicaid, are uninsured, or are medically underserved. By providing evidence-based tools, resources, and support, we’re helping to enhance quality care and address unique healthcare challenges in rural areas. Learn more about how AHRQ is working to improve health equity and outcomes in rural America. https://bit.ly/4ebTLne

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Abridge + Kaiser Permanente take the partnership plunge. In actively piloting various opportunities in the #AI-enabled scribe space, so far it’s obvious: • This solution has game-changed how I practice and my approach to outpatient clinic workflow. • I feel this solution impacts provider efficiency, decreases #PajamaTime spent after work, not with our family but rather buried in the EMR — thus giving us back what’s most important — our time. • I’d offer the biggest disruption is how this AI-enabled innovation allows me to be more human, increasing the doctor-patient connection and my ability to more directly engage eye-to-eye about my patient’s health. • With so much inertia in this particular space for AI Healthcare, I feel some applications/vendors have a product advantage, all need richer ability for bespoke customization, speciality-focused nuance, and added EMR application/back office integration. It will happen in time. 💥🎤⬇️: Combine this novel innovation with EMR voice-enabled orders and auto billing/charge capture capability - akin to the rotary dial on a telephone, one day we may no longer will need a keyboard to provide outpatient clinical care. Becker's Healthcare

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Strategic planning plays a crucial role in integrating ChatGPT into clinical practice for optimized outcomes. Health care organizations must address the limitations of ChatGPT in complying with the Health Insurance Portability and Accountability Act by deidentifying Protected Health Information. Patient perspectives on AI integration in health care, particularly in clinical note generation, raise concerns about privacy, accuracy, and communication with providers. Ethical transparency regarding AI's role in health care is essential to address patient worries about care quality and data management. To foster trust and uphold high standards in patient care, disclosure of AI usage, adherence to HIPAA regulations, and verification of AI-generated documents by health care professionals are vital steps.

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This measure highlights areas that are key to providing high-quality patient-centered care for older adults in the hospital. Over the last decade, we have developed Patient Priorities Care as an age-friendly approach that helps older adults focus decision-making and care on their goals and preferences. These goals and preferences are an integral part of the Centers for Medicare & Medicaid Services age-friendly hospital measure. #AgeFriendly #geriatrics #whatmatters #patientcenteredcare

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On September 23, the Centers for Medicare & Medicaid Services (CMS) held a webinar titled, “Transitional Coverage for Emerging Technologies Education Session.” The purpose of this webinar was to share information on the Transitional Coverage for Emerging Technologies (TCET) Medicare coverage pathway and answer questions from the public. Here are a few key takeaways: - TCET is designed to create a more efficient path for market access for breakthrough technologies. - The TCET pathway uses existing national coverage determination (NCD) and coverage with evidence development (CED) processes. - TCET is designed for devices that are not already in the market. Manufacturers can submit a nonbinding letter of intent to nominate a potentially eligible device approximately 18-24 months before the manufacturer anticipates FDA market authorization. - CMS will be proposing additional guidance on the fit-for-purpose study and real-world data protocols soon. - CMS will prioritize eligible devices based on its 2013 Federal Register notice, which states that CMS will prioritize requests based on potential impact on the Medicare program and its beneficiaries and staffing resources. A high impact on the Medicare program may be assessed based on a significant benefit from a relatively small number of patients or a modest benefit for a relatively large number of patients. CMS will consider whether a device will have a health equity impact. - CMS anticipates publishing new proposed prioritization guidance after working through several TCET quarterly review cycles. For more information about the TCET pathway, please click here: https://lnkd.in/dUjfdCc9

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A few weeks ago, as a healthcare leader, I had the opportunity to listen to Democratic and Republican politicians discuss healthcare at Wisconsin Hospital Association's Advocacy Day. It was a thought-provoking experience highlighting our healthcare system's complexities and challenges. One key takeaway from the discussion was the urgent need for bipartisan collaboration and innovative solutions to improve healthcare delivery and outcomes for all Wisconsinites. Both sides emphasized the importance of accessible, affordable, and high-quality healthcare for everyone, regardless of their background or socioeconomic status, though with very different approaches. In light of this discussion, I believe this where healthcare leadership can focus on driving positive change:  1. Patient-centered care: We as healthcare leaders must prioritize patient-centered care by putting patients at the forefront of decision-making processes. This involves listening to patient feedback, addressing their needs and concerns, and ensuring that healthcare services are tailored to meet individual preferences and requirements.   2. Collaborative partnerships: Building strong partnerships with stakeholders across the healthcare ecosystem is crucial. This includes collaboration with government agencies, insurance providers, healthcare providers, community organizations, and patient advocacy groups. By working together, we can create comprehensive solutions that address the diverse needs of our population.  3. Innovation and technology: Embracing innovation and leveraging technology can significantly improve healthcare delivery. From telemedicine and digital health solutions to data analytics and artificial intelligence, numerous opportunities exist to enhance efficiency, accuracy, and accessibility in healthcare services.  4. Health Equity: Addressing health disparities and promoting health equity should be top priorities. Healthcare leaders must strive to eliminate barriers to care, reduce inequalities in health outcomes, and ensure that all individuals have equal access to essential healthcare services.  5. Workforce Development: Investing in the development and support of healthcare professionals is essential for delivering high-quality care. This includes training programs, continuing education opportunities, mentorship initiatives, and promoting a culture of collaboration and respect within healthcare teams.  6. Financial Sustainability: Healthcare leaders need to navigate the complex landscape of healthcare financing while maintaining financial sustainability. This involves responsible resource allocation, cost-effective practices, and exploring alternative payment models that prioritize value-based care. By focusing on patient-centered care, collaborative partnerships, innovation, health equity, workforce development, and financial sustainability, healthcare leaders can contribute to a healthier, more equitable future for our communities. #WHAAdvocacyDay

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🚀 The future of healthcare lies in harnessing the power of AI and real-time data to enhance patient outcomes. As Dr. Ryan Nicholas, the chief quality officer of Mercy Medical Group-Dignity Health, recently noted in a recent Becker's Healthcare article, "Our future partnerships will increasingly include AI-driven, real-time transcription solutions and data analytics services." At Azra AI, we’re proud to be part of this transformative shift. Our end-to-end oncology platform delivers real-time analytics and intelligent workflow automation, empowering health systems to make data-driven decisions that truly impact patient care. From faster identification of #cancer diagnoses and suspicious incidental findings to streamlined care management, we’re helping oncology teams turn data into action — and improve the cancer journey for patients from day one. Read the full article about IT partnerships from Becker’s here: https://lnkd.in/gG6NUbDg #OncologyCare #AIinHealthcare #RealTimeData #AzraAI #PatientOutcomes #HealthcareInnovation #WinningTogether

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Two new proposed rules could be a game changer for health data interoperability... In early July (published in Federal Register August 5), ASTP/ONC released all 1,067 pages of its proposed HTI-2 rule, in which it proposed expanding its Certification Program to complement CMS' FHIR APIs. This included creating criteria impacting payers and public health IT. It reminded me of a line of questioning from ONC's electronic prior authorization RFI from January 2022, where the agency asked nearly ten questions about what certification criteria should look like to facilitate electronic prior authorization processes. The thought then, and even at the publication of HTI-2, was that certified modules wouldn't help payers much because payers are not the ones implementing modules. The vendors who provide the administrative platforms are. As it stands, there are only disincentives to certifying under the program for payer health IT vendors (i.e., bringing them under the information blocking rule), so payers are really at the mercy of their vendors. This is in stark contrast to the impact the program has on EHR developers. That was until HHS' ASFR and ASTP/ONC released another proposed rule on August 9 that would require all providers and health plans (that means you, MA plans) that receive HHS funding to use certified health IT or adhere to ONC standards at a minimum. So, what does this mean? Payers who receive HHS funding could now have the regulatory support to require their vendors to be certified... If passed as written, payer health IT vendors that want to maintain their contracts with federally funded plans would not be able to "unreasonably limit" the exchange, access, or use of electronic health information - including charging an unreasonable fee. They could be penalized up to $1M per violation if they do. This is a huge deal. Luckily, the team at Maverick Health Policy summarized both proposals (linked below). If you need help navigating these changes, we're here to help. HTI-2: https://lnkd.in/g4McbwMy Acquisition Regulation: https://lnkd.in/gWY--VPb

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What's next for healthcare? Come join me in D.C.! RISE is bringing together hundreds of policymakers, policy experts, and practitioners to discuss. I'll be moderating a discussion on "Experiences in Data Sharing and Information Exchange" in healthcare. Don't forget to use the SPK15 discount code. #sdoh #healthcare #socialdeterminantsofhealth #populationhealth #vbc #healthpolicy

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