Category: This Month in Digital Health

This Month in Digital Health News: Making AI Meaningful, Managing Climate Change Risk, and a Bunch of Other Stuff

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It’s time for This Month in Digital Health, where I highlight news articles that caught my attention and offer my take on why I think they matter. Along with the requisite stories about AI in healthcare, this month – fittingly when the Boston area is about to hit record high temperatures for this time of year – we’re looking into climate change and healthcare.

It’s all about meaningful AI utilization now. As half of healthcare organizations have now deployed generative AI, according to a McKinsey survey, attention has turned to tool integration and ROI. That means leaders are looking for meaningful transformation, not even more revenue cycle automation; that often comes down to using AI to solve readily identifiable problems. Meanwhile, because we just can’t have nice things, HHS wants to ditch requirements for transparency in AI tools, because reasons.

Add “climate change” to healthcare’s risk management agenda. First, the bad news: Hospitals in areas vulnerable to climate change haven’t done much to address climate-related health risks, in large part because of socioeconomic disparities. Next, the good news: Looking at climate change as a health equity issue and using existing long-term planning frameworks can help manage these risks. Plus, hospitals are reducing waste – no minimal matter, as the industry accounts for more than 8% of carbon emissions – and EMS and mobile clinics are buying hybrids.

Now, for a bunch of interesting odds and ends.

That’s all for now. Tune in next month when I’m sitting in front of the AC waiting for summer to end even though it hasn’t technically started yet. (One of my most unpopular opinions is that I strongly prefer the colder months of the year.)

This Month (or So) in Digital Health: AI’s Growing Pains, Federal Health’s Shrinking Pains

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Welcome to This Month in Digital Health, where I summarize news articles that recently caught my attention and attempt to try to put the trends in broader context. Stop me if you’ve heard this before, but one of the main themes this month is AI, which healthcare finally seems to be putting under the microscope. Also of note is how the Iran war will impact health systems and how federal health may be gutted yet again.

The honeymoon’s over for clinical AI. One study found clinicians save less than 30 minutes a day using AI scribes and don’t decrease their after-hours EHR use. Another one determined Epic’s algorithms don’t perform well in the real world, which matters because AI vendors struggle to compete with EHR incumbents even if their products work better. So, it comes as no surprise that healthcare’s struggling to calculate AI’s ROI and getting impatient when ROI is slow to arrive. On top of everything else, experts say AI oversight and governance need to catch up. Good times.

Consumers understand AI’s limitations. About one-third of American adults turn to AI with health-related questions. Don’t run around screaming that the robot doctors are taking over, though. Education and research make up more than half of healthcare AI queries, compared to 8% for care questions, and people readily admit they use AI because it’s convenient, not because it’s accurate. Seems like there’s most definitely some log-hanging fruit for all those consumer AI health tools (nearly diagramed by Rock Health).

Federal health funding? What federal health funding? The White House is proposing a 12% cut to HHS in 2027, though it’s worth noting Congress ignored a similar request last year. Even with funding restored, HHS is in disarray after massive job cuts (as are other federal agencies), as detailed in excellent long reads from Healthcare Dive. Also, 400-plus hospitals are at risk of closing due to Medicaid cuts that are projected to reach $1 trillion over the next decade.

Healthcare may feel the pinch of the Iran war. Disrupted shipping in the Strait of Hormuz may not impact medical supply chains immediately, and the uncertainty of what may come means stocking up is a bad idea. Cybersecurity is a more immediate threat, as “cyber conflict increasingly mirrors geopolitical tensions,” one expert told Healthcare Brew.

Prior authorization: Now with slightly less time wasted! The insurance industry patted itself on the back by eliminating 11% of prior authorizations, according to an AHIP statement. Meanwhile, Health Affairs found 90% of prior authorizations are approved the first time, which essentially means the $30 cost per transaction is paying for a rubber stamp.

In other relatively interesting news:

Thanks for playing along. See you next time.

This Month in Digital Health: Beyond the Conversations With Well-Dressed People in Cushy Chairs

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Welcome to This Month in Digital Health, where I summarize articles that recently caught my eye to explain why I think they’re important. With ViVE and HIMSS behind us, I figured I’d shy away from all the product and partnership announcements that made headlines, which explains why this is a bit shorter than usual. There were still some compelling stories out there, from the usual AI and rural health challenges to ruminations about how seemingly competing health data exchange efforts will in fact complement each other.

AI: Everything everywhere all at once at the same time. A Health Affairs paper argued healthcare needs its AI bubble to burst, as organizations are chasing “innovation without substance.” It doesn’t help that large language models are susceptible to misinformation (just like people), health systems are still wrestling with human-in-the-loop approaches (focusing too much on individual outputs and not enough on scalable frameworks), and LLMs are impacting how people interact with search results (fewer clicks on reputable hospital websites, which of course isn’t a good thing). If nothing else, I suppose, robots can run the hospital cafeteria.

Rural health: Because healthcare loooooves to rush into things. KFF Health News is all over rural health transformation, where proposals range from investing most of the money (Wyoming) to using robots in maternity care (Alabama). Plus, apparently there’s some tension about plans that were drafted and approved, in no small part because states didn’t really have a lot of time to come up plans. That very well may have been the point – I’ve heard folks argue that CMS was looking to fund projects that were well past the planning stage – but the whole thing’s starting to look rather messy, if not ill-conceived.

CMS: TEFCA and the Health Tech Ecosystem are totally besties. It’s not the best look when you launch a data-sharing initiative and then have to come out and say it’s not competing with an existing data-sharing initiative with similar characteristics and motivations, as CMS and ASTP had to do regarding TEFCA and the Health Tech Ecosystem. Apparently, the ecosystem is an “accelerator,” and its work may (or may not) be folded into TEFCA at some point. Glad we cleared that all up.

ACCESS: With rates this low, who needs a doctor? The proposed annual rates for the ACCESS model (Advancing Chronic Care with Effective, Scalable Solutions) are, um, well, they’re not very high at all. A lot of folks are arguing that’s exactly the point, as the model’s meant to attract 1) entities that take a digital-first approach to chronic care and 2) patients that don’t necessarily need a lot of in-person care. I get it, but I’m not sure going out of your way to alienate physicians is really the best approach.

In other news:

See you next month, when there will be 95% fewer healthcare IT articles featuring photos of well-dressed people sitting in comfy chairs and holding microphones.

This Month (and Last Month, Too) in Digital Health: It’s Been a Long Time, So Here Are Some Long Reads

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Welcome to This Month in Digital Health, which looks at trends that got my attention and attempts to unpack why I think they’re important. We’re actually looking at almost two months’ worth of stuff here, as life caught up with me in January. As a result, there’s less focus on hard news – besides, you already read about all those AI releases – and more on analysis and commentary that looked interesting to me.

Will Oracle have to sell the EHR formerly known as Cerner? Oracle has committed $500-plus billion to AI data centers – enough that the company may need to lay off 30,000 people and sell off Cerner, which it bought for more than $28 billion less than 4 years ago. One report suggested Amazon, Google, and Microsoft are probably the only companies with enough cash to buy Cerner – and even then, would they want it? (Or will Epic decide now’s as good a time as any to make its very first acquisition?)

Prior authorization is better, but still not the best. As of Jan. 1, the timeline for prior authorization responses is half as long as it used to be. But providers say 72 hours for urgent care decisions is still too long – I’m not a doctor, nor do I play one on TV, but I think they have a point – and add that “delays and hassles” persist. Payers have pledged to step up real-time decisions, but providers argue promises don’t equal actions.

Providers, payers are also at odds over bill disputes. The independent dispute resolution process kicked off years ago in response to the No Surprises Act. Payers accuse providers of attempting to inflate reimbursements, while providers argue the nuance of regulation favors insurers. Meanwhile, both wait for regulatory clarity, especially on what people can actually dispute.

Medicaid is in trouble. You already know that. The nation’s largest publicly operated health plan is L.A. Care, which serves 2.2 million Medicaid beneficiaries in Los Angeles County. The plan projects 30% of enrollees dropping off the rolls by 2028 – and straining the insurer’s finances – thanks to One Big Beautiful Act cuts. Process automation and other efficiency improvements can only do so much, I’m afraid.

A Medicare Advantage shell game in Arcadia. In parts of Oregon, Optum removed a bunch of doctors from Humana’s Medicare Advantage network just in time for open enrollment. Guess who was the only other MA insurer in those areas? If you guessed UnitedHealthcare – owned by the same company – then you win, um, well, no one really wins anything here. Not even the insurance giant, which expects revenue to decline in 2026 as it makes less money off Medicare Advantage.

New York bucks the patient data access trend. Various states have been extending protections for personal health information, what with HIPAA being 30 years old and all. Legislation in New York would have done the same – but Gov. Kathy Hochul vetoed the bill at the end of last year, citing a broad scope coupled with stringent frameworks “which may discourage innovation.” Critics said the veto is a win for Big Tech; others described the bill as onerous.  

Seniors are quitting weight-loss drugs in droves. Roughly half of Americans over 65 who were prescribed GLP-1s stopped taking them within a year. There are plenty of possible reasons, from bad side effects to muscle loss (a particular concern for older patients) to loss of insurance coverage. Weight-loss pills could help, particularly for patients who don’t like injections, but daily doses present their own challenges.

Inpatient surgery won’t be a cash cow much longer. CMS is signaling it aims to phase out the list of inpatient-only surgical procedures, meaning more will move to outpatient facilities. That could save money for patients (and payers) but cut revenue for hospitals already strapped for cash. One option for bucking the trend: Optimize operating room capacity, largely through standardized processes.

Is it time for digital therapeutics to shine? In December, the FDA launched TEMPO, a pilot program for digital therapeutics tied to chronic condition management. The program could breathe some life into a struggling market segment; participating medical professionals can prescribe therapeutics before they’ve received FDA clearance, and real-world data from users would in turn inform clearance decisions.

For PCPs, fewer patients doesn’t mean less EHR time. Providers that make a concerted effort to reduce visit volume don’t spend equally less time plonking about in their EHRs. Researchers found PCPs who cut visit volume by nearly one-third only spent 21% less time in the EHR – and dreaded “pajama time” actually increased. There’s a straightforward explanation: After reducing visit volume, the patients that PCPs had left were in fact more complex.

Enjoy the rest of February, everyone.

This Month in Digital Health: Some things are actually looking up!

~ iambeastwood ~ Leave a comment

Welcome to This Month in Digital Health, where I highlight articles and trends that recently caught my eye and attempt to explain why I think they matter. This time around, there’s actually maybe possibly some decent news about chronic care management and care at home, though rural health, AI, and support for the nursing workforce are all a bit messy.

AI is still complicated. HHS is setting a course to broaden AI adoption internally, with the hope of setting an example for the private sector to follow. It seems that healthcare organizations may benefit from any guidance they can get: They’re struggling with AI governance, feel underprepared for AI deployment, aren’t getting AI ROI fast enough, and aren’t yet seeing major productivity gains from AI.

Chronic care is getting good attention. CMS announced the ACCESS model for pay providers for using tech to support chronic disease management. Many see it as a “bold new model” for tech-enabled care, and vendors see it as an opportunity to prove their worth to providers who are typically skeptical of such things. That said, providers have a lot to consider when it comes to who to enroll, what tech to use, and how program structure ay change.

Finding rural health details the hard way. CMS isn’t talking about what states plan to do with Rural Health Transformation money, so KFF Health News filed public records requests and reported on the details. There’s a lot about improving access to food, medication, and lifestyle improvements – just not specifically for Native American tribes, who weren’t eligible to apply and have to rely on their state governments.

More care at home momentum? Former CDC director Susan Monarez penned a piece for Chief Healthcare Executive suggesting up to 90% of care can take place in the home. A JAMA Network Open study found care at home is especially effective in rural areas, which bodes well for programs looking to demonstrate value. Speaking of which, vendors are pushing for value-based contracts from Medicare, which would help with their own long-term stability.

The balancing act for supporting nursing teams. An interview with the Mayo Clinic in HealthTech Magazine (a client of mine, for the record) highlighted the benefits of AI to support nursing workflows – provided that nursing teams get a say from the get-go in what tools will do and how they’ll be implemented. Saving time should be a point of emphasis, as nurses who skip breaks or stay late are probably burning the candle at both ends.

Meanwhile, I found a bunch of odds and ends this month.

Happy Holidays. If you have children home from school for the next couple weeks, remember that no one’s going to judge you if they wear pajamas all day, eat candy for breakfast, and use every pillow and couch cushion in the house to make an obstacle course or fort – especially if you don’t tell anyone about it…

This Month in Digital Health: Confirming Things We Already Knew

~ iambeastwood ~ 1 Comment

Welcome to This Month in Digital Health. Here, I highlight news articles and trends that recently caught my attention and attempt to explain why they matter. The main theme for the last few weeks has been reports and stories confirming things we already knew – which is still important, because it always helps to hammer home the message.

AI is complicated. AI was a big talking point at HLTH, what with the AMA announcing its Center for Digital Health and AI (to develop policy and training resources, among other things) and the Cleveland Clinic CEO saying AI is necessary for solving big problems like access to affordable care. Easier said than done, though, as 49% of orgs are seeing AI innovation delayed, while AI’s many ethical issues resemble a can repeatedly kicked down the road and healthcare’s slow sales cycles leave AI vendors waiting for the check to come in the mail.

Insurers aren’t popular. Forrester found only 54% of consumers view health insurers are trustworthy, and only 53% understand claims decisions. Insurers are trying to curry favor by streamlining prior authorization, though most consumers said they’ll believe it when they see it. It certainly doesn’t help that 60% of consumers blame insurers for medical debt and 70% say healthcare is unaffordable – a problem that will get worse before it gets better.

Everyone wants ROI. Not everyone gets it. Half of digital health purchasers use performance-based contracts; the Peterson Health Technology Institute expects that number to rise as health plans, hospitals, and employers scrutinize contracts to ensure they deliver value. When it comes to virtual care, fewer than 30% of providers earn significant ROI, as Healthcare Dive put it, citing Sage Growth Partners. That might explain why Amwell is mulling the sale of legacy assets that aren’t part of its virtual care platform.

Private equity likes money. Two fairly damning reports from Health Affairs illustrate what private equity’s doing to healthcare. One found hospice facilities owned by PE had higher profits and lower per-patient spending compared to other ownership models, and another found specialists affiliated with PE negotiated higher prices than independent physicians. Mind you, other for-profit entities exist in healthcare, and non-profits don’t always hold up their end of the bargain; it’s still not a good look.

Other things we already knew or saw coming from miles away:

That’s all for now. Tune in next month to see if the trends are more of the same.

This Month in Digital Health: Everything Is Not Awesome

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Welcome to This Month in Digital Health, where I highlight news articles and trends that recently caught my attention and attempt to explain why they matter. The key theme for the month? Everything’s a mess.

Telehealth is in trouble. Medicare’s telehealth flexibilities expired at the end of September. With the federal government shut down and not authoring an extension, vendors and providers face a cliff, with some keeping services available and others opting not to. The hospital at home program faces a similar fate, as it too needs an extension from Congress to stay alive. Basically, care is now less accessible – just in time for flu season!

Rural health needs help. Applications are open for the Rural Health Transformation Fund – and just in time, what with multiple federal rural connectivity programs facing funding cuts. Amid the well documented rough road ahead, some rural providers are forming clinically integrated networks, though their aim is more about survival than about the traditional CIM focus on value-based care. Really, though – I feel like rural providers can and should do whatever it takes.

AI use isn’t equitable. HHS data released before the shutdown found an unsurprising digital divide in predictive AI use, with small, rural, independent, and critical-access providers all lagging. Groups such as the Coalition for Health AI fear safety net providers will only fall further behind unless they’re able to recruit the IT staff required to get AI efforts up and running. This is broadly consistent with pretty much every single type of healthcare IT, and sadly I don’t see it changing any time soon.

Insurance costs are going through the roof. No matter how you’re insured, you’re paying a lot more in 2026. Employers’ healthcare costs are poised to rise 9%, while Affordable Care Act premiums will increase close to 20% – and some will more than double is tax credits expire. The culprits? Drug costs (especially GLP-1s), the cost of care, and the impact of the One Big Beautiful Bill Act. Luckily, nothing else has seen significant price increases in the last year, right? Right?

Medicare Advantage is in trouble. Most MA insurers are scaling back their plan offerings in 2026, and annual premiums for the general MA population are expected to increase 22%. Many insurers are also trimming supplemental benefits from MA plans, too, as they say it’s getting too expensive to offer coverage. On a related note, non-profit MA plans didn’t fare terribly well in recent Stars ratings announcements. This all makes me wonder if the MA bubble is bursting: Though 54% of eligible beneficiaries are in MA plans, the pace of growth is slowing. (Remember the second derivative from AP Calculus?)

Also of note:

That’s it for now. Leave a comment if I missed something interesting. We’ll see you next month. Hopefully things will be less depressing.