{ }
More than half of health system leaders and insurance executives prioritize artificial intelligence, with 73% increasing financial commitments to the technology. Governance structures are being established to align AI with organizational values, focusing on use case identification, ethics, and data policies. While 76% are launching AI pilot programs, challenges like ROI and integration remain significant for both payers and providers.
A recent survey reveals that nearly 23% of insured Americans are underinsured, lacking affordable access to healthcare. Among these individuals, 57% avoided necessary care due to costs, and 44% are burdened by medical debt, leading to worsened health outcomes for many. The findings highlight significant barriers to timely healthcare access, particularly for those in employer plans and the individual market.
CerpassRx has partnered with Waltz Health to launch the Intelligent Specialty Engine, an AI-driven platform aimed at managing specialty drug spending. This collaboration enhances transparency and optimizes savings by routing prescriptions to cost-effective pharmacies while providing real-time analytics for health plans and employers. The platform is designed to improve the specialty drug experience and health outcomes through competition among pharmacies.
Aetna, part of CVS Health, has launched SimplePay Health, a new health plan designed for self-insured clients that simplifies the member experience and reduces costs. The plan features a bundled payment model, allowing members to pay a copay for all covered services, with no deductibles or co-insurance, and provides a single monthly statement summarizing claims. Internal data indicates a 60% increase in the use of high-quality providers and a 12% reduction in total care costs for employers and members.
Hospital operating margins rose to 5.1% in September, marking a slight increase from previous months, while U.S. health systems experienced a decline to 1.6%. Year-over-year, gross hospital revenues saw significant increases, particularly in outpatient revenue, despite month-over-month declines. Patient demand showed mixed results, with outpatient visits up 3.8% YOY but down 6.4% from August to September.
The American Medical Association and the Illinois State Medical Society have filed a lawsuit against MultiPlan, alleging involvement in a price-fixing conspiracy with health insurers that has led to unfairly low payments for out-of-network services. This scheme, reportedly in operation since 2015, has harmed both patients and physicians, forcing many medical practices to close or limit services. The lawsuit seeks to reform the out-of-network payment systems reliant on MultiPlan's practices, which have significantly increased the company's revenues while suppressing physician payments.
In 2023, 389 U.S. healthcare institutions faced ransomware attacks, leading to significant operational disruptions and financial losses, with downtime costing up to $900,000 daily. The median ransom paid by 99 organizations was $1.5 million, reflecting a troubling trend as 67% of healthcare organizations reported attacks, with 53% paying ransoms. Ransomware now accounts for over 70% of successful cyberattacks in the sector, which experiences nearly four times the global average of cyberattacks.
Waltz Health is partnering with Noom to launch a comprehensive and affordable weight loss program focused on GLP-1 management. Utilizing Waltz Connect, the initiative aims to enhance price transparency and accessibility for employees needing GLP-1 prescriptions, while also reducing costs for employers. The program is part of Noom Med, which combines evidence-based obesity care with behavior change strategies to promote sustained weight loss.
Healthcare executive pay rose by 4.6% this year, consistent with last year's growth, with system-level executives seeing higher increases (5.2%) compared to subsidiary hospital executives (3.5%). Despite challenges like rising labor costs and cybersecurity threats, total cash compensation for system-level executives increased by 8.3%, driven by improved performance and incentive awards. Recommendations include enhancing compensation offers to attract talent and updating executive pay structures to reflect role criticality and market demands.
The U.S. healthcare system ranks last among 10 countries in access, equity, and outcomes, despite spending over 16% of its GDP on healthcare. Key issues include high costs, a fragmented insurance system, and significant numbers of uninsured and underinsured individuals, leading to poor health outcomes and limited access to care. Recommendations for improvement include extending coverage to the uninsured, reducing administrative complexity, and investing in public health.
Trending
Subcategory:
Countries:
Companies:
Currencies:
People:

Machinary offers a groundbreaking, modular, and customizable solution that provides advanced financial news and statistical analysis. Our platform goes beyond traditional quantitative analysis, offering users a comprehensive understanding of real-time market dynamics, event detection, and risk analysis.

Address

Waitlist

We’re granting exclusive early access to the first 500 users from december 20.

© 2024 by Machinary.com - Version: 1.0.0.0. All rights reserved

Layout

Color mode

Theme mode

Layout settings

Seems like the connection with the server has been lost. It can be due to poor or broken network. Please hang on while we're trying to reconnect...
Oh snap! Failed to reconnect with the server. This is typically caused by a longer network outage, or if the server has been taken down. You can try to reconnect, but if that does not work, you need to reload the page.
Oh man! The server rejected the attempt to reconnect. The only option now is to reload the page, but be prepared that it won't work, since this is typically caused by a failure on the server.