Real Artificial Intelligence
Advanced Data Systems Corp
Revenue Cycle Management, Practice Management & Medical Billing Software, EHR, and RIS.
“Real artificial intelligence” sounds oxymoronic and even silly, yet it’s anything but that. As just reported in the Wall Street Journal, patients may be getting AI-generated advice vs. that same type of advice directly from their physicians.
AI in the form of OpenAI’s GPT will be able to read patient messages and reply with automatically drafted responses from their doctors without having to involve the doctors directly. The concept is that this will cut the time needed for medical staff to respond to patients’ questions.
UC San Diego Health and UW Health (Wisconsin) began testing in April with the intent of rolling out this month.
Are you ready for this? ChatGPT, another AI-driven app, actually scored better than real doctors at responding to patients’ questions according to an article in JAMA Internal Medicine.
Relating to physician burnout, physicians are hopeful this type of AI functionality will help curtail that. But might this type of AI, as it becomes more and more perfected, represent a threat to physicians? Obviously, physicians/providers are still needed to treat patients, perform procedures, issue prescriptions, etc.
The question is, as we move more into a braver new world, how far will AI be able to go? We will see…
Vacating the COVID-19 Vaccine
What has been a big shot in the arm for Pfizer, Moderna, and J&J, the COVID-19 vaccine requirement is now coming to an end for certified CMS healthcare facilities, Head Start educators, and non-citizens at border crossings. Vaccines as were needed for federal employees, contractors, and international air travelers will also be curtailed.
This is scheduled to begin on May 11 which is the same date the overall pandemic public health emergency is slated to end.
Modifier 25
If this was Jeopardy!, it would be something like this:
Category: Medical Coding
The $1,000 answer (it’s difficult): Modifier 25
The question: What caused over 100 healthcare associations to take issue with Cigna?
But this isn’t Jeopardy! so here’s what happened:
Cigna notified its network of providers that it will “ding” payments for E/M claims with Modifier 25 “if records documenting a significant and separately identifiable service” are not submitted with the claim. Modifier 25 records and bills for E/M service on the same day of another service or procedure when it is performed by the same physician or provider.
A letter to the Cigna CEO explained the providers understood inappropriate use of Modifier 25 should be prevented, but still, Cigna’s new policy on that is burdensome, and that it would result in an inordinate amount of notes having to be sent with claims.
Click here to read the five-page letter dated 4/18 which also includes a listing of signed-on organizations.
Medical Liability Premiums might need Insurance
It’s almost like medical liability insurance needs insurance, with premiums growing by over 10% or more in 15 states. In Kansa, “or more” means an increase of almost 41%. The list of states having a greater than 10% increase in 2022 is:
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Overall, an AMA analysis showed that over 35% of medical liability increased in 2022.
Lackluster Primary Care Participation in Value-Based Care
According to a recent survey, fee-for-service (FFS) is very much alive and well in the primary care arena vs. operating under value-based (VB) care. “Very much alive” means about 70% of PCPs reported they still received FFS payments in 2022 with the remainder getting reimbursements through VB care models.
This said, the industry continues in its effort to shift to VB payments and as such, more work is needed to encourage primary care to adopt and embrace a VB care approach.
MedicsRCM and our team helps clients in all specialties who want to transition more into VB care.
Click here for the Commonwealth Fund article and survey.
The MATE Act
It has kind of a funny ring to it, but it’s not funny if you’re a DEA-registered physician or practitioner. If you are, you’ll be required to take eight hours of training in order to apply for or renew your license to prescribe on or after 6/27/23. The only exception: practitioners who are solely veterinarians.
That’s the date the Medication Access and Training Expansion Act goes into effect, despite the “unintended consequence” concerns expressed by the AMA.
Click here for the DEA’S explanatory MATE Act letter and details, and here for the AMA’s content.
A Next Wave in Healthcare: Physician Retirements
According to MGMA, nearly two in five practicing physicians will reach age 65 in the next ten years. Of course, that’s the traditional age at which people retire. That fact, combined with an increasingly overall aging population, is expected to be the main reason for a looming physician shortage.
This comes on the heels of another MGMA report from 8/22 describing how physician burnout, even before the pandemic and no doubt in conjunction with it, has contributed to physicians exiting the profession.
Some good news is the data, again per MGMA, indicates a number of physicians reaching 65 won’t fully retire but will ramp down to more part-time status.
The suggestion is to “take the temperature” of physicians in your setting to get a handle on how to prepare for the future.
Your Other Staffing Issues
Providers represent one of two sides to your staffing. The second side involves your administrative, and front-of/back-of-house staff. That group continues to present staffing issues for all types of medical practices and settings. A common problem happens when a main or key billing person leaves or becomes abruptly unavailable, or even if they leave with some advanced notice. Either way, the setting is often hard-pressed to replace that person, and it can be quickly thrown into turmoil.
It’s a great reason to consider working with an outsourced workforce.