Artificial intelligence (AI) in health care has become the subject of both great promise and great hyperbole. Beyond buzzwords and a plethora of venture capital investments, AI and other mathematical techniques are beginning to emerge in a second wave of domain-specific systems of intelligence. The key missing factor has been a business model in the payer-and-provider community that enables the "best" (aka: most validated, most clinically proven, most workflow-integrated) models to drive an economic value both to the care paradigm and to the cost centers of health care data storage and analytical processing. As the cloud storage wars have entered health care, a question has emerged: Beyond security and the improved economics of cloud storage versus physical storage, what will drive revenue for cloud vendors? Furthermore, how will horizontal cloud vendors prove the validity of AI offerings to impact the business needs of providers and payers such as improved quality, decreased workload and better outcomes?
To the editor: Yes, California could do single-payer healthcare. Unfortunately, it would be a complete disaster. It would be too expensive, and one state is too small a risk pool, but the real reason it would fail is the incompetence of the government. Medicare, for example, faces insolvency despite pleas from the trustees to address the issue. The Department of Veterans Affairs program is an embarrassment.
The timing for the value sets is crucial as payers and providers alike need to be prepared for the operational and financial challenges that will inevitably arise when the public health emergency expires. For payers developing their own strategies for supporting telemedicine services after the pandemic, specialty-specific value sets that define those diagnoses and services that are most likely to be utilized in a telehealth setting will be critical for configuring claims systems, defining benefits, setting fee schedules, and identifying clinical needs within a patient population for targeted intervention. In addition to these new value sets, content from Health Language will empower payers to stay ahead of a changing regulatory world to prepare their claims payment, benefits management, and provider relationship systems accordingly. For providers embracing telehealth, these value sets can help stratify patient populations to identify those most likely to benefit. Whether primarily a fee-for-service or quality payment-based organization, telehealth, remote patient monitoring, and chronic care management services are proven to add clinical and financial value.
LOS ANGELES – With ObamaCare broken and the GOP effort to replace it uncertain, California and a handful of other liberal states are proposing to adopt a European-style, single-payer health care system where residents pay the state and the state provides care – regardless of income, occupation, or health status. "If you look at the financing of a single-payer system, what you'll find is it saves money if it's done right," says supporter Jamie Court of Consumer Watchdog. "That's why every other country in the world pays two-thirds less. It gets rid of the insurance companies." Lawmakers in New York, New Jersey, Rhode Island and Massachusetts proposed single-payer bills this year.
Kamala Harris says she would like to pass a single-payer health care bill. It's just not clear how serious she is about it. During a town hall event in Iowa on Monday, CNN's Jake Tapper pointed out that the California senator, who is running for president, had co-sponsored the Medicare for all bill written by Bernie Sanders, which would put all Americans on one government-run health plan and ban private insurers from offering competing coverage. "So for people out there who like their insurance, they don't get to keep it?" Harris, to the surprise of many, leaned into the question with a firm no.