Health Technology, AI
Article | July 18, 2023
Anesthesia groups face major challenges in the aftermath of the pandemic: Financially strapped hospitals are increasingly unwilling or unable to pay anesthesia subsidies, and a shortage of qualified anesthesiologists and CRNAs is making recruitment extraordinarily competitive.
The good news is that anesthesia opportunities are plentiful in the ambulatory surgery center (ASC) market. As more inpatient procedures migrate to ASCs, anesthesia practices can help meet demand by working with hospitals and ASCs. A dual-contracting approach can help increase revenue, reduce operational risk, enhance recruiting leverage, and present opportunities for equity investments in ASC ventures.
Expanding ASC Case Mix
Multiple factors are driving increased ASC volume.Consumers have long been attracted to the convenience andfast turnaround timesASCs offer, and as the pandemic began to take hold and patients worried about becoming infected in hospitals, theirpopularityincreased.
But even before the pandemic hit, theuse of ASCs was growing,with the number of centers increasing 7.1% annually since 2016.1No doubt this was in part driven by Medicare restricting fewer surgeries to the inpatient only (IPO) setting. This year alone, Medicare is adding 11 orthopedic procedures to the ASC-approved list, including total knee arthroscopy (TKA) and total hip arthroscopy (THA).2Commercial payersare alsofuelingASC volume by promotingthis venue as a lower-cost option to members.Lastly, with more than 90% of ASCs at least partially owned by physicians,providers themselvesare driving moreprocedures to this setting.
Hospitals Become ASC Buyers
For years, hospitals viewed ASCs as direct competition and discouraged or even prohibited inpatient anesthesia practices from contracting with them. But that dynamic is changing as more hospitals become buyers or majority investors.
According to a recent survey, the percentage of hospitals and health systems planning to increase their investments in ASCs rose from 44% in 2019 to 67% in 2020, with 75% of 200-plus-bed hospitals already owning more than one ASC.3Hospitals view these investments as a way to enhance physician relationships and increase surgical capacity.
The Benefits of Practice Diversification
For anesthesia practices that elect to contract with both hospitals and ASCs, a key benefit is improved profitability, since average ASC case reimbursements are higher than average hospital cases due to better payer mix and more efficient room turnover. Groups that work with multiple organizations also reduce their institutional or operational risk by limiting their exposure to potential financial problems associated with a single contracted entity.
Practices likewise gain an edge when it comes to recruiting in today’s highly competitive anesthesiologist and CRNA market. One of the chief benefits of ASC involvement is being in a position to offer a better work-life balance by spreading call responsibilities across a larger physician call pool. The math is simple: If a hospital group has seven physicians, each must provide call coverage once a week. But if the group also contracts with five ASCs and brings on five additional doctors to staff the facilities, individual call responsibilities are reduced to once every 12 days.
The importance of mitigating call duties to improve the work-life balance for both experienced clinicians and new hires can’t be overstated, particularly as hospitals work to streamline OR throughput by increasing the number of surgical procedures. Groups can also explore a range of creative compensation approaches, including essentially selling call opportunities to newly hired or recent graduate anesthesiologists as additional avenues to attract qualified clinicians while easing the burden on senior anesthesiologists.
Equity Opportunities
Among the most intriguing aspects of ASC involvement is the potential for becoming an equity stakeholder in the business. Surgeons traditionally have been the primary drivers in creating ASCs, but new opportunities exist for anesthesiology groups, particularly if their hospital is buying an existing ASC or developing a new ASC venture and looking to diversify the ownership group.
The idea of anesthesia ownership isn’t as crazy as it might sound. Like surgeons, anesthesiologists are integral to the success of an ASC, and like surgeons, they get there early and stay late. It’s no secret that joint ownership can greatly improve relations between the practice and the hospital, since both are now working toward the same objectives.
Groups can also make more money. I met with a surgical group not long ago with a 49% ownership stake in a hospital. That equity generated an additional $80,000 per year for each physician partner. How much you can make, of course, depends on your specialty, your level of ownership, and the volume of business. But you’ll never know until you try.
Outside Expertise
The pandemic has unleashed numerous changes throughout healthcare, and where the dust will eventually settle isn’t entirely clear. But what is certain is that for organizations to remain viable, they’ll need to be flexible and look hard at nontraditional business opportunities. Contracting with both hospitals and ASCs represents one such approach for anesthesia groups.
If you’re interested in exploring this and other business possibilities but don’t know where to start, Change Healthcare can help. Our team of expert anesthesia practice-management consultants have an average of 18 years’ experience in the specialty. We can be engaged on a per-project basis or we can provide our consultant services as part of our turnkey anesthesia-billing solution.
Our anesthesia revenue cycle management services can be deployed either on our own proprietary anesthesia-billing platform or on your hospital billing system. Either way, we’ll provide seamless, end-to-end service.
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Healthtech Security
Article | August 31, 2023
Artificial Intelligence is here to improve our lives, by not just making things more efficient, but also increasing our lifespan. Companies across industries are experiencing the advantages that come with AI innovation, especially the healthcare space. Throughout human history, we’ve been able to understand the parameters that determine health better, and we’ve developed accompanying technology. With vaccines in the late 1700s, anesthesia and medical imaging in the 1800s, to organ transplant and immunology in the 1900s, healthcare innovation has been on an upward slope.
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Healthtech Security
Article | November 29, 2023
Healthcare is top of mind as the coronavirus hits hard everywhere. The inefficiencies of the system itself are on full display during the pandemic — where testing is hard to come by, diagnoses and treatments are reactive rather than proactive, and many people do not get the care they need, when they need it. Adrian Aoun, CEO and founder of Forward, a tech-driven healthcare startup, told Karen Webster that it’s possible to build a completely new healthcare ecosystem, beginning with primary care — and the overhaul needs to leverage data and artificial intelligence (AI).
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Article | December 15, 2020
As medical science has improved rapidly, life expectancy around the world also has risen. Still, as longevity increases, healthcare systems are facing a growing demand for advanced services, increased costs, and a struggling workforce to meet various requirements of patients. Demand is driven by many unstoppable forces: a shift in lifestyle choices, shifting patient expectations, population aging, and the never-ending cycle of innovation are a few among others.
Challenges Faced by the Healthcare Industry
According to Mckinsey, one in four people in North America and Europe will be over the age of 65 by 2050. This shows that, soon, the healthcare industry will have to deal with a larger number of patients with more complex requirements. Catering to these patients is expensive and requires health systems for providing long-term focused and proactive care. To remain sustainable, healthcare systems need major transformational and structural changes.
The industry also needs a larger workforce because according to the World Health Organization (WHO), globally there is a shortfall of approximately 9.9 million nurses, physicians, and midwives. Apart from attracting, training, and retaining these healthcare professionals, you also have to ensure that their time and effort add value to patient care. Utilizing the solutions powered by modern technologies, such as Artificial Intelligence (AI) in the healthcare industry, will add perfection and more value to human efforts.
AI in the healthcare industry has the potential required to transform and revolutionize healthcare by addressing the challenges in the industry mentioned earlier. AI can better the outcomes, improve efficiency, and augment productivity in healthcare delivery. This article takes an in-depth look at the impact of AI in healthcare.
Impact of AI in the Healthcare Industry
In the coming years, AI in the healthcare industry will improve the day-to-day life of healthcare practitioners, augment the patient experience, improve care delivery, and can even facilitate life-saving treatments and revolutionize the industry. Additionally, AI will improve population-health management, operations, and strengthen innovations.
According to Statista, the global AI healthcare market will increase to more than US$28 billion by 2025. Here is a detailed look into the areas where and how AI in the healthcare industry will be impactful.
Chronic Care Management
Chronic diseases, such as cancer, diabetes, kidney diseases, are the leading cause of disability and death in the US and the main drivers of the country’s annual health cost. Effectively managing various chronic diseases is an overarching and long-term process. But with the help of the right tool, healthcare providers can meet the needs of these patients without delay.
Artificial intelligence tools in the healthcare industry can help healthcare providers overcome the complexities of chronic disease management and make it more effective and provide quality treatment. AI in the healthcare industry is increasingly being leveraged by organizations to improve chronic disease management, enhance patient health, and drive down costs, which will also eventually result in data-driven and personalized care. AI in the healthcare industry is expected to move the industry toward proactive care delivery from a reactive one and lead the industry to provide more individualized treatments. This is just one of the ways AI in the medical industry is going to revolutionize chronic care management in hospitals.
Care Delivery
Artificial intelligence in the healthcare industry is changing the way care is delivered; it is expected to make healthcare more efficient, accurate, and accessible. Reducing costs and improving health outcomes are the values health systems and hospitals are trying to deliver to patients every day. Hospitals are increasingly incorporating technologies, which are powered by the use of AI in healthcare to meet the challenge.
According to the American Hospital Association (AHA), AI in the healthcare industry has unlimited potential to solve most of the vexing challenges in the industry. They identify AI use cases in the healthcare industry in four broad areas, which are administrative, operational, financial, and clinical areas.
Administrative Use Cases for AI in the Healthcare Industry
• Admission procedures
• Appointment scheduling
• Customer service responses
• Discharge instructions
• Hiring and orientation protocols
• Licensure verification
• Patient check-in procedure
• Prior authorizations
• Quality measure reporting
Operational Use Cases of AI in the Healthcare Industry
• Inventory management
• Materials management
• Supply chain management
• Facilities management
Financial Use Cases for AI in the Healthcare Industry
• Billing and collections
• Claims management
• Insurance eligibility verification
• Revenue cycle management
Clinical Use Cases of AI in the Healthcare Industry
• Predictive technologies
• Interventional technologies
By incorporating and utilizing these scopes with AI in the healthcare industry, the industry can be transformed into a next-gen level in no time. It also allows healthcare practitioners to focus more on patients, which would eventually help in raising staff morale and improving retention.
Clinical Decision Support
Recent advancements in AI in the health industry are capable of enhancing the currently used clinical decision support (CDS) tools to have value-based imaging and to improve patient safety. According to the National Institute of Health (NIH), the synergy between CDS systems and AI in the healthcare industry will be able to:
• Reduce friction in radiology workflows
• Identify relevant imaging features easily
• Generate structured data to develop machine learning algorithms
• Enable an evolution toward decision support for a holistic patient perspective
• Suggest imaging examinations in complex clinical scenarios
• Assist in identifying appropriate imaging opportunities
• Suggest appropriate individualized screening
• Aid health practitioners to ensure continuity of care
AI in the healthcare industry is competent in making CDS a next-gen one, enhancing the experiences of radiologists and providers, and improving patient care.
Diagnostics
Slowly but surely, AI is improving almost every aspect of human life with innovations and advancements. The latest is that AI in the healthcare industry is impending a revolution in medical diagnostics by providing accurate risk assessments, accelerating disease detection, and boosting hospital productivity. By automatically prioritizing urgent cases and accelerating reading time, image recognition AI enhances the workflow of radiologists. It even helps in the prevention of diseases by the early detection of diseases.
In medical images such as x-rays, MRIs, and CT scans, AI-driven software can efficiently be used to accurately spot signs of many diseases, especially in detecting many chronic diseases such as cancer. According to the NIH, AI will be widely applied in the healthcare industry especially for various tasks such as patient engagement and adherence, diagnosis, and treatment recommendations. So, there is no doubt that AI in healthcare will revolutionize the diagnostic process in the approaching years by detecting diseases, classifying diseases, and improving the decision-making process. The application of AI in the healthcare industry will make people live longer.
Triage and Diagnosis
AI can be effectively used to automatically triage cases. AI algorithms will analyze the cases and forward cases to pathologists after determining the priority based on the probability of cases according to the criteria set by labs. This makes the workflow of pathologists easier and efficient. Through the process the algorithm will be able to:
• Verify the digital images attached to the case belong to that case
• Validate the tests ordered and match the specimen type
• Identify cases marked as stat
• Determine the cases, which can be positive or are most likely to be negative
Moreover, AI technologies in the healthcare industry also can be effectively used to provide more accurate and faster diagnoses. This speeds up the entire process of triage and diagnosis and is expected to revolutionize the healthcare industry soon.
The Future Outlook for AI in the Healthcare Industry
Over the next few years, AI in the healthcare industry has the best opportunities in hybrid models to support clinicians in diagnosis, identifying risk factors, and in treatment planning. This scope will result in faster adoption of AI technology in healthcare, which will show measurable improvements in operational efficiency and patient outcomes.
With a plethora of issues to overcome, which are driven by documented factors such as growing rates of chronic diseases and the aging population, it is obvious that the healthcare industry needs new innovative solutions. AI-powered solutions in the healthcare industry will achieve a clear impact on the global healthcare industry in a short time.
Frequently Asked Questions
Which is the best application of AI in the healthcare sector?
Cognitive surgical robotics is the best application of AI in the healthcare sector as it helps practitioners collect data from real surgical processes, which would help in improving existing surgical approaches.
Why is artificial intelligence important in healthcare?
Artificial intelligence in healthcare is vital as it can help make decisions, analyze and manage data, and have conversations. So, AI will drastically change the everyday practices and roles of clinicians.
When was AI-first used in healthcare?
The term, Artificial intelligence (AI) was first described in 1950, but the limitations of the term prevented its acceptance. In the 2000s, these limitations were overcome and people started to accept the term.
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