The ACA and ‘Medicare for All’
Surprise Billing
- Keeping patients out of the middle of payer-provider disputes and protecting them from surprise bills/insurance gaps
- Fair reimbursement for physician services, including an independent dispute resolution process which has been proven to be highly effective in several states that already employ this approach
- Improving transparency in healthcare
Entering 2020, surprise billing will remain at the center of legislative discussions. In the meantime, states will likely continue to address the matter with statewide legislation. On Jan. 1, 2020, four new surprise medical billing laws took effect in Colorado, Nevada, Texas and Washington. [iii]
AI Advancement
The promise of Artificial Intelligence (AI) is not a new concept to healthcare, but the role it will play hasn’t always been clear. Discrete application of AI-enabled technologies is ushering micro changes throughout healthcare.
Increasingly, health systems are focusing on specific tools that can support the organization’s needs, enhance capabilities, and augment human experience. In theory, a number of digital health technologies will improve care and access to care but adopting these tools should not happen all at once. Strategy is key when introducing new technologies in order to maximize the potential of the technology.
Examples of AI-technology integrations include:
- RCM Models/Coding: Process automation lowers costs and improves reliability.
- Patient Experience Chatbots: Chatbots enhance the patient experience using immediate response to guide patients to appropriate resources and escalate problems or concerns in real-time.
- Physician & Clinical Team Member Experience: Voice recognition technology improves work-flows and reduces EHR “click fatigue”.
- Detect & Diagnosis: Identifying trends utilizing existing data and providing further data to augment clinical decision support.
Interoperability
More organizations are recognizing data should be able to help tell us where we are going, not just where we are. It needs to help identify issues before they occur. Data needs to be widely available and shared across the entire care continuum to drive outcomes. The delivery of accessible, real-time data driven insights will be key to enhancing longitudinal continuity of care.
Not all organizations or health systems have the financial resources to adopt a 100% interoperable framework. However, we will likely see an upward trend in the number of organizations prioritizing digital strategies to support these technologies.