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What does AI mean for patients in bed and doctors at the bedside? Host Chip Kahn and guest Dr. Robert Wachter, Chair of the Department of Medicine at the University of California, San Francisco, discuss whether AI will produce a different kind of doctor in the future — a “clinician curator rather than a clinician-diagnostician.” The answer could define the future of medicine and the doctor-patient relationship.
More than half of all Medicaid beneficiaries now receive their services in risk-based managed care plans, and states’ use of managed care is expanding. States operate their own Medicaid managed care programs within federal rules and requirements. The federal regulations were last updated in 2002 and a new proposed rule is expected in Spring 2015. This brief identifies key issues in the regulation and discusses how CMS might address them.
On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.
This comprehensive survey of the experiences of New Orleans residents is the third in a series conducted by the Kaiser Family Foundation since 2005. Five years after Hurricane Katrina, an increasing majority of the city’s residents says the rebuilding process is going well, but substantial majorities still report that the city has not recovered and feel the nation has forgotten them. The survey also finds the scope and immediacy of the Gulf oil spill weighing heavily on…
How is AI applied to clinical care and hospital operations across a real health system at full scale? Chip Kahn talks to Dr. Michael Schlosser, Senior Vice President and Chief Transformation Officer at HCA Healthcare, about how AI is developed for everyday use, starting with careful testing and customization, with clinicians and nurses engaged from the very beginning as end users.
California’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation, insuring almost one-third of Californians. For several decades, Medi-Cal has been transitioning from a fee-for-service (FFS) system to risk-based managed care, and more than three-quarters of all Medi-Cal beneficiaries, including low-income children, adults, seniors, and people with disabilities, are now enrolled in managed care plans. As other state Medicaid programs increase their reliance on risk-based managed care, a review of California’s transition…
State Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. This brief examines what delivery system and payment reform initiatives are in place across states; how are states linking financial incentives and using transparency to improve quality and outcomes; and how are states leveraging managed care plan contracts to advance delivery system…
Is AI Better for patients? What is changing on the ground? Chip talks with Dr. Patrick Conway, Chief Executive Officer of Optum, a health services and technology business under parent company, UnitedHealth Group. They discuss how to ensure the health care industry’s use of AI serves patients first, particularly when the same company bears financial risk and builds the AI that decides who gets care. They also discuss whether use of AI can make value-based…
In his latest column for The Wall Street Journal's Think Tank, Drew Altman explores whether Secretary Burwell's announcement this week about Medicare's payment reform initiative is another sign that the public sector is becoming the engine driving payment and delivery reform. All previous columns by Drew Altman are available online.
In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses whether the Centers for Medicare and Medicaid Services' broad new responsibilities implementing the Affordable Care Act and a more proactive approach to Medicare payment signals that it’s time for (another) name change.
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