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Chip talks with Dr. Toyin Ajayi, co-founder and CEO of Cityblock Health, which delivers value-based care to more than 100,000 Medicaid and dual-eligible members across ten states, many of them people of color managing chronic conditions. Ajayi makes a pointed case: Roughly 60 percent of health care AI investment goes to billing, coding, and risk adjustment — making sure someone gets paid — while only a fraction goes to delivering care. If we continue to…
In a conversation focused on the technology underlying AI in health care, Chip is joined by Seema Verma, former administrator of the Centers for Medicare & Medicaid Services (CMS), and now Executive Vice President and General Manager at Oracle Health and Life Sciences, the second largest electronic health records (EHR) platform in the U.S. Seema shares her insights on the evolution of EHRs and why it’s necessary to redesign these systems to better integrate AI capabilities and improve the quality of care.
The Alliance for Health Reform and co-sponsors presented the second event in a three-part series of discussions on costs, the factors driving them up, and what (if anything) can be done about them. This briefing takes an in-depth look at two of the most often cited cost drivers - technology and chronic conditions. For more information, please visit the Alliance's event page. Full Video: Part One Part Two The panel is moderated by…
This conference report summarizes discussions at a March 2018 conference in Washington with 30 leaders from the health care community to launch Initiative 18/11, a partnership between the Society of Actuaries and KFF to address the rising cost of health care in the United States. It also lays out the next steps for the initiative.
Under the ACA, states have a new Medicaid option to establish "health homes" designed to improve care coordination and integration and reduce costs for beneficiaries with chronic conditions. Thus far, 15 states have implemented health home programs. Following on a 2012 brief profiling Medicaid health home programs in the first six states to adopt the option, this brief describes the health home programs in the nine states that have implemented them since that time, and…
A number of states have used the flexibility of the Medicaid program to develop innovative payment and delivery systems designed to coordinate and improve quality of care. This brief, based on site visits from November 2009 through March 2010, highlights care coordination and related efforts in five states: Alabama, Oklahoma, Oregon, Pennsylvania and Washington state. Such efforts by states to realign the provider payment and delivery systems are key to improving Medicaid and to successfully…
Caroline Pearson, executive director of the Peterson Health Technology Institute (PHTI) and the Peterson Center on Healthcare, joins Chip to discuss who really benefits as AI moves into health care's back office. A quiet arms race is underway — providers deploying AI to code, bill, and capture revenue and insurers deploying it right back to review, deny, and hold the line. The open question is whether any of this lowers what the country actually spends…
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